- Evolent (Lansing, MI)
- …mission. Join a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer , Nurse, you will be a key member of the utilization management ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse, you will routinely interact...**What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases,… more
- Trinity Health (Livonia, MI)
- …the integrity of clinical documentation through the roles of reviewer , educator and consultant. Facilitates the overall quality , completeness, accuracy ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position Utilizes advanced clinical and coding expertise to… more
- Prime Therapeutics (Lansing, MI)
- …that meet clinical review criteria. Refers all cases not meeting clinical criteria to pharmacist clinical reviewer . + Practices and maintains the ... drives every decision we make. **Job Posting Title** Initial Review Pharmacy Technician - Remote **Job Description**...requests to nurse, pharmacist or physician on the utilization review clinical team when further review… more
- Trinity Health (Livonia, MI)
- …and proper documentation requirements as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality ... and quality outcomes. Serves as a resource for appropriate clinical documentation. Responsible for scheduling and staffing assignments for the Clinical… more
- Trinity Health (Livonia, MI)
- …within their region. Performs quality reviews as outlined in the CDI quality plan, such as by Clinical Documentation Specialist (CDS), service line, focus ... CMI as well as ICD-10 coding systems and the guidelines related to Clinical Documentation Integrity. Provides direction for daily review assignments and… more
- Prime Therapeutics (Lansing, MI)
- …fuels our passion and drives every decision we make. **Job Posting Title** Clinical Account Executive Supporting Florida Client - Remote **Job Description** ... role will support a Florida Client - open to remote with preferred candidate to reside in Florida and...clinical products, clinical initiatives, participation in clinical meetings, continuous quality improvement execution and… more
- Prime Therapeutics (Lansing, MI)
- …our passion and drives every decision we make. **Job Posting Title** Policy Clinical Pharmacist- REMOTE **Job Description** Creates new and updates existing ... not limited to, responding to inquiries, customization of policies, Client policy review , education, QBR support, clinical meetings, audit assistance, special… more
- Prime Therapeutics (Lansing, MI)
- …our passion and drives every decision we make. **Job Posting Title** Clinical Pharmacist (Algo), Professional-Senior- REMOTE **Job Description** Maintains the ... projects as determined by business needs. + Collaborating with Clinical Operations, IT, Quality , and Compliance as...collaborate and work well as a team. + Data review and interpretation skills required. **Preferred Qualifications** + Managed… more
- Molina Healthcare (Detroit, MI)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... illness and the site of service. The Lead, HCS ( Clinical ) functions as clinical staff lead in...daily administrative functions including staffing schedules, productivity, and work quality . This position will support our Molina One Care… more
- Prime Therapeutics (Lansing, MI)
- …fuels our passion and drives every decision we make. **Job Posting Title** Clinical Account Director Remote **Job Description** **This is an Individual ... Contributor/Client Facing Role.** The Clinical Account Director is responsible for the management of...$124,000.00 - $211,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our… more