- Trinity Health (Ann Arbor, MI)
- …(pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/ Utilization Review personnel, as needed. Obtains and ... (pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/ Utilization Review personnel, as needed. Obtains and… more
- Henry Ford Health System (Jackson, MI)
- GENERAL SUMMARY: Under general direction, the Respiratory Therapist-Clinical Specialist (RT-CS) provides direction and supervision in the role of on-site Respiratory ... specializes in a care location or patient population. The specialist is the lead or senior practitioner who is...of all Respiratory Therapy patients. Monitors attendance, productivity and utilization of labor, supplies and services in a fiscally… more
- Corewell Health (St. Joseph, MI)
- …role model for staff pharmacists. + Coordinates and implements departmental drug utilization review efforts and other process improvement activities as assigned. ... right in their community.Lakeland Care Network is a partnership between your physician and Corewell Health Lakeland. We are the largest Accountable Care Organization… more
- Corewell Health (Grand Rapids, MI)
- …general direction, is a liaison for health plan initiatives with physician hospital organizations, physician organizations state-wide and community entities. ... programs to ensure objectives are achieved. + Responsible for the analysis, review and dissemination of network performance information, including but not limited to… more
- Trinity Health (Howell, MI)
- …(pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/ Utilization Review personnel, as needed. Obtains and ... verifies the accuracy and completeness of physician orders for tests and procedures, which includes name,...and skills competencies such as the Certified Revenue Cycle Specialist Professional (CRCSP) through the American Association of Healthcare… more
- Trinity Health (Livonia, MI)
- …within their region. Provides direct oversight of the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator. Working with the Regional ... directly responsible for the daily assessments of current Clinical Documentation Specialist staffing levels and processes. Ensures that defined goals are… more
- Cognizant (Lansing, MI)
- …experience. * Experience in the analysis and processing of claims for payments, utilization review /quality assurance procedures. * Must be able to work with ... is required. **Travel:** None required **About the role:** As Claims Adjudication Specialist , you will be responsible for timely and accurate adjudication of… more