- Sedgwick (Lansing, MI)
- …need for absence from work. **ESSENTIAL FUNCTIONS and RESPONSIBILITIES** + Performs clinical review of referred claims; documents decision rationale; and ... Fortune Best Workplaces in Financial Services & Insurance Disability Clinical Specialist **PRIMARY PURPOSE** : To perform clinical...completes medical review of all claims to ensure… more
- University of Michigan (Ann Arbor, MI)
- Clinical Pharmacist Generalist-Oncology & Infusion Pharmacy Services (OncCore) - Afternoons Apply Now **Mission Statement** Michigan Medicine improves the health of ... together enhance our contribution to society. **Why Join Michigan Medicine?** As a Clinical Pharmacist Infusion at Michigan Medicine, you will practice in a variety… more
- CVS Health (Lansing, MI)
- …team (department Associate Managers, Manager, and other key stakeholders such as Medical Directors, account teams/ clinical liaisons, etc.) to ensure consistency ... Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care… more
- Ascension Health (Stephenson, MI)
- …**Responsibilities** Facilitate improvement in overall quality, completeness and accuracy of medical record documentation. + Complete admission reviews and assigns a ... Ensure the working DRG and other information are entered in the Clinical Documentation Improvement database. + Initiate and maintain extensive interactions with… more
- Molina Healthcare (Grand Rapids, MI)
- **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are ... medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated… more
- Molina Healthcare (Ann Arbor, MI)
- …compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- Henry Ford Health System (Warren, MI)
- …criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical experience ... of hospital resources and the quality of patient care rendered. Combines clinical , business, regulatory knowledge, and skill to reduce significant financial risk and… more
- Fresenius Medical Center (East Lansing, MI)
- …direct patient care staff on appropriate programs under the supervision of a nurse . + Provides developmental support to applicable clinical and facility staff. ... for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training...Related** + Participates in the recruitment process for new clinical staff + Assists with clinical orientation… more
- Fresenius Medical Center (Zeeland, MI)
- …direct patient care staff on appropriate programs under the supervision of a nurse . + Collaborates with the Clinical Manager and Education Coordinator in ... dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance… more
- Fresenius Medical Center (Chesterfield Township, MI)
- …effective dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies procedures and training and in compliance ... last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and...activities. + Enters all treatment data into the designated clinical application accurately and in a timely manner. +… more