- 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
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of previously denied… more
- 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
- 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
- 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
- Molina Healthcare (Ann Arbor, MI)
- …leadership skills. **Required License, Certification, Association** + Active, unrestricted State Registered Nursing ( RN ) in good standing. + MULTI STATE ... targeted member population, and triage activities. + Completes staff quality audit reviews. Evaluates services provided and outcomes achieved and recommends… more
- 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
- 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
- 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
- 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