- CVS Health (Lansing, MI)
- …Management. - Refer all cases that do not meet applicable criteria or have a potential quality of care issue to a physician reviewer . - Identify and address ... with heart, each and every day. **This is a remote work from home role anywhere in the US...AHH delivers flexible medical management services that support cost-effective quality care for members. - This position consists of… 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
- Molina Healthcare (MI)
- …are highly preferred Work hours: Monday- Friday 8:00am - 5:00pm Central time Remote position **Essential Job Duties** * Performs clinical /medical reviews of ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal...provided to members. Contributes to overarching strategy to provide quality and cost-effective member care. Candidates with UM and… more
- Trinity Health (Livonia, MI)
- …Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position Responsible for directing Clinical Documentation Integrity ... quality outcomes. Serves as a resource for appropriate clinical documentation. Develops CDS team through hiring, maintaining work...regulatory standards are met. Ensures that direct reports perform clinical validation as part of the review … more
- Evolent (Lansing, MI)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... clinical professionals. + A role that values innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be… more
- Molina Healthcare (MI)
- JOB DESCRIPTION **Job Summary** The RN Care Review Clinician 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… more
- Henry Ford Health System (Warren, MI)
- …the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Combines clinical , business, regulatory ... assessments from admission through discharge, problem identification and education, facilitates the quality of health care delivery in the most cost effective and… more
- Parexel (Lansing, MI)
- …the trial team. + Medical responsibility as co-author for development of a robust Clinical Quality Monitoring Plan (CQMP) in line with the critical data, medical ... Clinical Study Physician. This is a fully remote role! Oncology, Inflammation or CMR preferred** The Study...trial CQMP (and its amendments). + Execution of relevant clinical quality monitoring for Study Physician using… more
- University of Michigan (Ann Arbor, MI)
- …processes to enhance subject safety during the conduct of all diverse clinical studies. Oversees regulatory documentation for quality assurance. Contributes to ... Qualifications Clinical Research Coordinator Senior: + CRC Governance Committee review and approval + Bachelors degree in Health Science or an equivalent… more
- University of Michigan (Ann Arbor, MI)
- …manager in establishing data management processes to ensure streamlined systems and high- quality data collection + Review participant requested grocery orders, ... ) + Minimum 2 years of directly related experience in clinical research and clinical trials is necessary. Please review SoCRA's Definition of a Clinical … more