• Organizational Quality Nurse Specialist

    Hospice of Michigan (Ann Arbor, MI)
    …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... Requires two to three years related quality and accreditation experience. + Current RN licensure in State of Michigan and maintain such licensure in accordance with… more
    Hospice of Michigan (12/10/25)
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  • Supervisor, Clinical Documentation Integrity (CDI)…

    Trinity Health (Livonia, MI)
    …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... to enhance clinical and coding skill sets and optimal utilization of the 3M CDI software. Responsible for scheduling...(CCS) + Licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion… more
    Trinity Health (11/24/25)
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  • Surgical Support Technician - McLaren Careers

    McLaren Health Care (Pontiac, MI)
    …Communicates effectively and reports relevant observations of patient status to responsible Registered Nurse and follow through as directed. 10. Respects patient ... activities that occur in a sterile environment. 3. Demonstrates competency in utilization of specified equipment required for patient care, including but not limited… more
    McLaren Health Care (01/15/26)
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  • Multi-Site Director Case Management

    Prime Healthcare (Port Huron, MI)
    …computer skills. Preferred qualifications: 1. Healthcare professional licensure required as Registered Nurse , Licensed Clinical Social Worker (LCSW), or Licensed ... to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses needs… more
    Prime Healthcare (12/31/25)
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  • Payment Integrity Clinician

    Highmark Health (Lansing, MI)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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  • Assistant Manager Patient Care Services…

    McLaren Health Care (Lansing, MI)
    …professional nursing experience providing broad clinical exposure. Current State of Michigan Registered Nurse license. + BLS certification as Healthcare Provider ... accomplish the mission and vision of McLaren Greater Lansing through effective utilization of all resources, constantly striving to increase quality patient care and… more
    McLaren Health Care (01/14/26)
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  • Transplant Care Nurse (Remote)

    Highmark Health (Lansing, MI)
    …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or… more
    Highmark Health (01/10/26)
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  • Appeals Nurse

    Evolent (Lansing, MI)
    …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (12/24/25)
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  • Integrated Care Management Assistant Case…

    McLaren Health Care (Port Huron, MI)
    …pay period:** **Schedule:** **Position Summary:** Responsible for providing assistance to the RN and SW Care Managers in the coordination of discharge and transition ... facilitating discharge planning to expedite a successful transition of care. 2. Assists RN and SW Care Managers with the referral process by collecting and… more
    McLaren Health Care (01/03/26)
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  • Clinical UM Nurse

    CenterWell (Lansing, MI)
    …**Use your skills to make an impact** **Required Qualifications** + Must be a licensed Registered Compact Nurse license ( RN ) with no disciplinary action and ... our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical… more
    CenterWell (01/14/26)
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