- Corewell Health (Royal Oak, MI)
- …and implementation performance evaluations, OPPE/FPPE, etc. Represents APPs to outside review services such as Joint Commission, American College of Surgeons etc. ... area of expertise or as determined by the APP Director or VP of APP Services. Note: This is...practices and monitoring metrics such as reimbursement, productivity, and utilization . + Act as central oversight for CE/CME policy… more
- Trinity Health (Ann Arbor, MI)
- …managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the ... Urology surgeons, and Plastic surgeons and under the direction of the Clinical Director of Advanced Practice Providers (APP). Under the direction of the surgeon and… more
- Humana (Lansing, MI)
- …identified gaps. They will work closely with established functions inside utilization management (Medical Director , clinician decision making teams, quality ... thresholds and identify appropriate actions when controls indicate process gaps. + Review appeal overturns and provider complaints about coverage policies to make… more
- Munson Healthcare (Traverse City, MI)
- …Min/Preferred Certification, Licensure, Registration Comments Minimum Licensed as a Registered Nurse in the State of Michigan OTHER REQUIREMENTS . For those ... according to accepted standards of clinical nursing practice. b. Assists in the utilization of the PCSS database to ensure appropriate staffing ratios. c. Promotes… more