- Integra Partners (Troy, MI)
- …for a LPN/LVN experienced in the managed care payor environment to perform pre- service and post- service utilization reviews and appeals for DMEPOS. This ... UM program. Salary: $60,000.00/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse 's responsibilities include but are not limited to: + Perform… more
- McLaren Health Care (Mount Pleasant, MI)
- …and Responsibilities:** * Assists in maintaining the Hospital's and Nursing Service 's philosophy through effective nursing care. * Makes staffing adjustments to ... Nursing Administration. * Promotes interdepartmental relationships. * Ensures that Nursing Services policies and procedures are followed. * Maintains and submits… more
- Molina Healthcare (MI)
- **JOB DESCRIPTION** **Job Summary** The Delegation Oversight Nurse provides support for delegation oversight quality improvement activities. Responsible for ... National Committee for Quality Assurance (NCQA), Centers for Medicare and Medicaid Services (CMS), state Medicaid entity requirements and all other standards and… more
- Gentiva (Grand Rapids, MI)
- …between physician, patient/family and hospice team. + Provide direct patient care services to hospice patients and supportive care to the patient's family with ... quality assessment and performance improvement programs. **About You** **Hospice Registered Nurse / RN Case Manager Requirements:** + Hospice heart: compassionate,… more
- Corewell Health (St. Joseph, MI)
- …For Outpatient Services - 3900 Hollywood Rd - St Joseph Department Name Cancer Health Services - CHS Employment Type Part time Shift Day (United States of ... Job Summary As a Nurse with Corewell Health , providing top-notch...facilitates a smooth transition to the next point of service / home. + Identifies, facilitates, and evaluates outcomes… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager (RN) - 2506003132 Description : DMC Detroit Receiving Hospital , Michigan's first Level I Trauma Center, helped pioneer the evolution ... a continuum through effective resource coordination to help patients achieve optimal health , access to care and appropriate utilization of resources, balanced with… more
- McLaren Health Care (Port Huron, MI)
- …assigned staff. * Protects organization's value by keeping resident's personal health information confidential per HIPAA guidelines. + Adheres to facility's safety ... control policies. + Participates in and completes all mandatory in in- services and educational opportunities as directed; maintains professional licensure. +… more
- McLaren Health Care (Petoskey, MI)
- Position Summary: Under direct supervision, provides personal and homemaking services to ill, convalescing, elderly, and disabled persons in the patients' home. ... or equivalent. ⦁ Successful completion of a written home health /hospice competency test and the clinical skills testing. ⦁...and the clinical skills testing. ⦁ Certification as Home Health Aide (CHHA). ⦁ State of Michigan CNA Certification… more
- McLaren Health Care (Port Huron, MI)
- …members, hospital personnel, Marwood Nursing & Rehab staff members, physicians, social services , and community organizations to ensure all aspects of the admission ... negotiation, organizational, analytical and time management skills. Demonstrate proficient customer Service skills; previous experience in customer service role,… more
- Molina Healthcare (MI)
- **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse (RN) provides support for internal appeals clinical processes - ensuring that appeals requests are ... policies and procedures, and medically appropriate clinical guidelines. Assesses appropriateness of services , length of stay and level of care provided to members.… more