• Nurse Audit Manager

    Humana (Lansing, MI)
    …managers across the department. **Use your skills to make an impact** **Required Qualifications** + Registered nurse ( RN ). + 5 or more years of clinical ... expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager, you will spearhead audit and validation processes to ensure… more
    Humana (08/13/25)
    - Related Jobs
  • Diagnosis Related Group Clinical Validation…

    Elevance Health (Dearborn, MI)
    …and efficiency recommendations. **Minimum Requirements:** + Requires current, active, unrestricted Registered Nurse license in applicable state(s). + Requires a ... **Diagnosis Related Group Clinical Validation Auditor- RN ** **Virtual:** This role enables associates to work...clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise,… more
    Elevance Health (08/09/25)
    - Related Jobs
  • RN Supports Coordinator

    Area Agency On Aging 1-b (Southfield, MI)
    The RN Supports Coordinator (SC) uses person-centered principles to perform comprehensive assessments to determine health care, social needs of applicants, and ... AgeWays' mission and values. Duties Include: + Conducts dual discipline in-person RN assessments for the purpose of evaluating MI Choice Program eligibility.… more
    Area Agency On Aging 1-b (08/08/25)
    - Related Jobs
  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Warren, MI)
    …state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing. ... to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides supporting documentation for… more
    Molina Healthcare (08/08/25)
    - Related Jobs
  • Quality and Accreditation ( RN ) Manager

    Helen Newberry Joy Hospital (Newberry, MI)
    …improving the quality of life in our community. Position: Quality and Accreditation ( RN ) Manager Job Status: Full Time; Monday - Friday, occasional weekend Required ... quality improvement + Responsible for leadership of the internal audit program to assess compliance with quality standards and...of quality and continuous improvement + Acts as occasional RN supervisor in long term care + Assists Infection… more
    Helen Newberry Joy Hospital (08/08/25)
    - Related Jobs
  • Director, Risk Adjustment Prospective Operations…

    Corewell Health (Grand Rapids, MI)
    …implementing risk adjustments programs for Medicare Advantage or ACA products. Preferred + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan Upon ... goals including but not limited to provider incentive programs, audit and compliance processes and well as EMR optimization...Hire required Or + LIC- Registered Nurse ( RN ) - State… more
    Corewell Health (07/21/25)
    - Related Jobs
  • Nurse Education Coordinator

    Grace Health (Battle Creek, MI)
    …current on best practices and ensure staff education meets standards Requirements: + Current Registered Nurse ( RN ) license in Michigan + BLS certification ... Full-Time | Monday-Friday Grace Health is seeking an experienced Registered Nurse to join our education team!...our education team! In this dynamic role, you'll help audit and support clinical staff, lead quality improvement initiatives,… more
    Grace Health (08/07/25)
    - Related Jobs
  • Nursing Director Inpatient and Hemodialysis

    Tenet Healthcare (Detroit, MI)
    …clinical and/or progressively more responsible management experience. 3. Licensed to practice as a Registered Nurse ( RN ) in the state of Michigan. Job : ... requirements and DMC policies. As directed, implements external and internal audit recommendations. Ensures hospital departments achieve objectives for diversity of… more
    Tenet Healthcare (07/30/25)
    - Related Jobs
  • Clinical Quality Nurse Specialist

    Hospice of Michigan (Kalamazoo, MI)
    …every time, 100% of the time. Qualifications: + Bachelor of Science in Nursing preferred. Registered Nurse ( RN ) licensure in the State of Michigan required. ... support of the mission of NorthStar Care Community. The Clinical Quality Nurse Specialist is responsible, through monitoring and supporting clinical staff, for… more
    Hospice of Michigan (08/09/25)
    - Related Jobs
  • Manager, Care Management

    Humana (Lansing, MI)
    …in Michigan and be able to travel to Wayne County or Macomb County.** + **Active Registered Nurse ( RN ) license or Social Work (SW) license in the state ... management and / or disease management activities. + Develop audit plans and tools for teams to ensure compliance...Minimum 5 years of professional experience as a licensed RN or Social Worker to include experience in case… more
    Humana (06/28/25)
    - Related Jobs