- CVS Health (Lansing, MI)
- … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review… more
- University of Michigan (Ann Arbor, MI)
- …as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review on ... RN CASE MANAGER: University Hospital (Care Management...is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm...Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure… more
- McLaren Health Care (Bay City, MI)
- …duties as required and directed. #LI-LM1 **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... **Department:** Utilization Management **Shift:** Days **Daily Work...established SOP procedures. 8. Maintains current knowledge of hospital utilization review processes and participates in the… more
- Corewell Health (Dearborn, MI)
- …management , utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... all hospitalized patients. + Identifies patients that need care management services (ie utilization review ;...accredited school of nursing. + Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing… more
- 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 ... room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG guidelines. Preferred… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review /case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager ( RN ) - 2506003132 Description : DMC Detroit Receiving Hospital , Michigan's first Level I Trauma Center, helped pioneer the ... for case management scope of services including: Utilization Management supporting medical necessity and denial... experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Molina Healthcare (Sterling Heights, MI)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
- Trinity Health (Ann Arbor, MI)
- …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
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