- Molina Healthcare (Detroit, MI)
- …experience, including hospital acute care/medical experience (STRONGLY DESIRED)** + **Registered Nurse with Claims and CIC coding experience (STRONGLY DESIRED)** ... **_For this position we are seeking a (RN) Registered Nurse who must be licensed for the state of...Payment Integrity strategies through both pre-payment and post payment claims reviews, aligning with industry and corporate standards as… more
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- …LTC Charles S. Kettles VA Medical Center is seeking a Full-Time Registered Nurse (RN) - Clinical Risk Manager Program Manager aligned under Patient Safety. ... the event of an adverse event Processes small tort claims for the facility and acts as a liaison...experience. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases,… more
- LG Energy Solution (Holland, MI)
- Title: Occupational Health Nurse , Specialist (Part Time or Full Time) Reports to: Health & Safety Manager Location: Holland, MI LG Energy Solution Michigan Inc. ... leader in advanced EV batteries! www.lgenergymi.com Summary The Occupational Health Nurse is responsible for the prevention, recognition, and treatment of on-the-job… more
- LG Energy Solution (Holland, MI)
- Title: Occupational Health Nurse Reports to: Manager, Health & Safety Location: Holland, MI LG Energy Solution Michigan Inc. (LGESMI) develops and manufactures large ... leader in advanced EV batteries! www.lgenergymi.com Summary The Occupational Health Nurse is responsible for the prevention, recognition, and treatment of on-the-job… more
- Otsuka America Pharmaceutical Inc. (Lansing, MI)
- The Patient Nurse Case Manager (PNCM) is a dynamic, field-based role that serves as a crucial educator for patients. This position helps to execute against a ... you will be reimbursed, this is not Otsuka. These claims are fraudulent and you are strongly advised to...legitimate job opportunity. Scammers may also send offers or claims from a fake email address or from Yahoo,… more
- Elevance Health (Dearborn, MI)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... + Performs in-depth investigations on identified providers as warranted. + Examines claims for compliance with relevant billing and processing guidelines and to… more
- CVS Health (Warren, MI)
- …And we do it all with heart, each and every day. **Case Manager Registered Nurse ** WFH Flexible This role will be 25-50%% travel within **Wayne or Macomb Countie** ... + Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that… more
- Molina Healthcare (Ann Arbor, MI)
- …outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases ... of a formal appeal being submitted. + Independently re-evaluates medical claims and associated records by applying advanced clinical knowledge, knowledge of… more
- CVS Health (Lansing, MI)
- …+ Conducts assessments that consider information from various sources, such as claims , to address all conditions including co-morbid and multiple diagnoses that ... + 3+ years clinical practical experience as an Registered Nurse (RN) + Candidate must have active and unrestricted...+ Candidate must have active and unrestricted Michigan Registered Nurse (RN) licensure + Candidate must be willing and… more
- Elevance Health (Dearborn, MI)
- **Telephonic Nurse Case Manager I** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager I** is responsible for performing care management within… more