• Multi-Site Director Case Management - LHMI

    Prime Healthcare (Port Huron, MI)
    …Provides leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... positive and supportive work environment. Responsibilities The Regional Director of Case Management will be responsible for the operations of the Case Management… more
    Prime Healthcare (10/13/25)
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  • Medical Director (AZ)

    Molina Healthcare (Sterling Heights, MI)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/17/25)
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  • Lead Care Management Techynician Full Time…

    Tenet Healthcare (Detroit, MI)
    Lead Care Management Techynician Full Time Days - 2506003325 Description : DMC Sinai-Grace Hospita l is DMC's largest hospital, offering a comprehensive heart ... application, effective processes and clinical service accountability for the Bed Management Process. Assists in the implementation of policies and procedures related… more
    Tenet Healthcare (10/07/25)
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  • RN Clinical Manager

    CenterWell (Portage, MI)
    …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
    CenterWell (09/06/25)
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  • Patient Care Manager - Full Time (32 Hours/Week)

    Munson Healthcare (Traverse City, MI)
    …customer service/interpersonal skills at all times. + Maintains working knowledge/experience in utilization management , managed care, and payer issues that may ... have RN license or social work license). If Registered Nurse , must be licensed to practice in Michigan. Also,...progress of completing complex post-acute services + Interface with utilization review specialists to stay current on… more
    Munson Healthcare (10/15/25)
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  • Job Posting Title NP/PA Surgical Subspecialty…

    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 ... Education** : Master's Degree in clinical nursing from an accredited Nurse Practitioner Program with emphasis on area of certification/licensure. **NP Licensure**… more
    Trinity Health (10/01/25)
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  • Care Manager II

    AmeriHealth Caritas (Detroit, MI)
    …and accurate documentation of member interactions in the electronic care management platforms. + Monitor appropriate utilization and coordinate services ... member's health status and compliance with treatment plans, as well as promote self- management . **Work Arrangement:** + Remote - The Associate must reside in the… more
    AmeriHealth Caritas (08/27/25)
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  • Regional Manager, Clinical Documentation Integrity…

    Trinity Health (Livonia, MI)
    …(CDI) activities for the Health Ministries (HM) in their defined region and day-to-day management of the CDI programs. Works with Director, CDI to ensure the program ... to enhance clinical and coding skill sets and optimal utilization of 3M CDI software. Analyzes data to determine...direct reports perform clinical validation as part of the review process and remain current on CDI strategies. Uses… more
    Trinity Health (10/08/25)
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  • Supervisor, Clinical Documentation Integrity (CDI)…

    Trinity Health (Livonia, MI)
    …as it relates to reimbursement and other clinical data quality management for colleague training. Provides quality and productivity monitoring; coordinates and ... specialists (CDS) to enhance clinical and coding skill sets and optimal utilization of the 3M CDI software. Responsible for scheduling and work assignments… more
    Trinity Health (08/26/25)
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  • Administrative Supervisor - PRN Night Shift

    Munson Healthcare (Traverse City, MI)
    …will be required to be in the role. Preferred Additional education in management principles and teaching is preferred. Preferred Graduate Degree MSN Required 5 ... Min/Preferred Certification, Licensure, Registration Comments Minimum Licensed as a Registered Nurse in the State of Michigan OTHER REQUIREMENTS . For those… more
    Munson Healthcare (09/23/25)
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