- Integra Partners (Troy, MI)
- …and medical necessity criteria (eg, InterQual, CMS, health plan policies). + Review and process clinical and administrative appeals; coordinate with Medical ... The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership...team performance, escalating issues as needed to the UM Clinical Manager. + Ensure compliance with all regulatory, contractual,… more
- Molina Healthcare (Sterling Heights, MI)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... least 2 years experience, including experience in hospital acute care, inpatient review , prior authorization, managed care, or equivalent combination of relevant… more
- State of Michigan (Kalamazoo, MI)
- Registered Nurse Manager 12-Kalamazoo Psychiatric Hospital Print (https://www.governmentjobs.com/careers/michigan/jobs/newprint/5098576) Apply Registered Nurse ... information, please visit our MDHHS Diversity, Equity, and Inclusion Plan. Registered Nurse Manager 12-This position is charged with the responsibility for the… more
- Select Medical (Battle Creek, MI)
- …highly effective level of care. **Qualifications** **What we're looking for in a Clinical Liaison** **Required Skills:** + Registered Nurse (RN) or Respiratory ... + Will consider other designations like LPN, PT, OT, etc., upon further review . + Ability to complete clinical assessments of medically complex patients.… more
- Molina Healthcare (Sterling Heights, MI)
- …**Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Henry Ford Health System (Detroit, MI)
- …ensuring seamless transitions between care levels. This position requires strong clinical judgment, excellent communication skills, and a deep understanding of ... patient outcomes and promote efficient resource utilization. Key Responsibilities: Clinical Care Coordination: + Conduct comprehensive patient assessments to… more
- Henry Ford Health System (Jackson, MI)
- …Adult Position Overview: Henry Ford Health Jacksonis seeking a full-timeCardiovascular Nurse Practitioner (NP) or Physician Assistant (PA)to join our team. The ... ICU-level monitoring. Candidates must be able to manage patients aged 18 and older. Prior OR experiencesuch as RNFA or first assist and vein harvesting skills are… more
- Henry Ford Health System (Plymouth, MI)
- …Overview: Henry Ford Plymouth Medical Center is seeking a dedicated and skilled Nurse Practitioner (NP) or Physician Assistant (PA) to join our Emergency Medicine ... wound care, foreign body removal, and splinting. While preferred qualifications include prior experience as an Emergency Department APP, candidates without direct ED… more
- Henry Ford Health System (Novi, MI)
- Licensed Practical Nurse LPN - Ambulatory Gastroenterology - Novi Location Full Time - 40 hours - 5 - 8 hour shifts. Monday - Friday. LPN's will function in both ... clinical and provide direct patient care. Rooming patients, vitals,...items, cleaning rooms, in-basket, medication refills under standing order, review prep instructions w/patients, etc. Will rotate between colon… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …health system in the country, our 220-acre main campus, and our network of clinical sites across Michigan. We are a tight-knit community of healers who witness the ... 90-180 days. What Will You Do? As a Graduate Nurse (RN) at Pine Rest, you'll be part of...co-workers and external customers. + Provides care in various clinical settings with diverse person's served populations. Identifies specific… more