- University of Michigan (Ann Arbor, MI)
- …and judgment, to resolve locally or determine if the issue should be escalated . The credentialing specialist autonomously conducts the final analysis thoroughly ... appropriate, by applying expert knowledge, expertise, and experience. Acting as a specialist in the complex Michigan Medicine credentialing process has the authority… more
- Molina Healthcare (MI)
- …appropriate criteria with chief medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and ... **Required Qualifications** * At least 3 years clinical nursing experience, with at least 1 year of managed care experience in the specific programs supported by the… more