- Molina Healthcare (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Further details to be discussed during our interview process. Remote - requires RN license Work schedule: Saturday...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required… more
- University of Michigan (Ann Arbor, MI)
- …as assigned DAILY WORK DUTIES 1. Insurance Alert Changes from software system for utilization management : notify RN CM if additional clinicals are required ... Utilization Management Assistant (Patient Services Intermediate)...authorization for services from third party payers and notify RN Case Manager of issues with authorizations 4. Enter… more
- CenterWell (Lansing, MI)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- University of Michigan (Ann Arbor, MI)
- …such as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review ... RN CASE MANAGER: University Hospital (Care Management...Identify opportunities for cost reduction and participate in appropriate utilization management venues + Conducts referrals and… more
- CenterWell (Grand Rapids, MI)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... Location** : Grand Rapids, MI **This is not a remote or work-from-home position. This position requires you to...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Molina Healthcare (Detroit, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Detroit, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet ... to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (Detroit, MI)
- …and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** Looking for a RN that has a current active unrestricted license...appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports… more
- Sharecare (Lansing, MI)
- …appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting...with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the… more
- Trinity Health (Livonia, MI)
- …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager, Clinical Documentation… more