- University of Michigan (Ann Arbor, MI)
- …Care Management, Registration, MiVisit Business services, clinics and ancillary departments. + Review patient medical records and utilize clinical and regulatory ... Utilization Rev Appeals Spec Apply Now **Job Summary**...Audit and Appeals Specialist has a strong knowledge of medical appeal and audit practices for both the inpatient… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …and peer review . Participates and facilitates implementation of modern care, utilization of new technologies and new procedures. This includes but is not limited ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA offers a comprehensive total rewards… more
- Corewell Health (Royal Oak, MI)
- …Graduate of AMA recognized PA program that is accredited by the Accreditation Review Commission on Education for Physician Assistants and meet requirements of ... Job Summary Physician Assistants (PA) are graduates of an accredited...signature. Reports to Manager APP PA. Essential Functions + Utilization of a high degree of discriminative judgement while… more
- Corewell Health (Dearborn, MI)
- …Graduate of AMA recognized PA program that is accredited by the Accreditation Review Commission on Education for Physician Assistants and meet requirements of ... you join our team at Corewell Health. Full-time, Day Shift Job Summary Physician Assistants (PA) are graduates of an accredited educational program and are… more
- R1 RCM (Detroit, MI)
- …transform the patient experience and financial performance of hospitals, health systems, and medical groups. We are the one company that combines the deep expertise ... sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Physician Advisor** , you will help our client facilities navigate the… more
- Molina Healthcare (Detroit, MI)
- JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting ... * Provides telephone, clerical and data entry support for the care review team. * Provides computer entries of authorization request/provider inquiries, such as… more
- Molina Healthcare (Detroit, MI)
- …practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease ... productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy … more
- Molina Healthcare (Sterling Heights, MI)
- …practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment, disease ... productivity standards. Educates and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy … more
- Corewell Health (Grand Rapids, MI)
- …of the guiding principles will be demonstrated through applications of evidence-based utilization review process and application of sound clinical judgement. The ... include review of previous clinical decisions by Priority Health Medical Directors (appeals). There will be opportunities to clinically contribute to discussions… more
- Munson Healthcare (Traverse City, MI)
- …Duties Include: Medical Director Duties - Clinical (75%), Administrative (25%) + Medical Supervision . The Physician shall provide overall medical ... and federal, state and local laws and regulations. Periodic medical reviews shall be conducted by the Physician...the total needs of the patient. + The proper utilization of appropriate treatment for patients. + The necessary… more