- Humana (Lansing, MI)
- …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... Previous experience in utilization management and/or utilization review . + Minimum of two (2) years of proven experience in management or leadership… more
- Henry Ford Health System (Warren, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... required. + Bachelor of Science Nursing required OR four (4) years Case Management / Appeal/ Utilization Management experience in lieu of bachelor's degree.… more
- McLaren Health Care (Grand Blanc, MI)
- …Three years of recent case management , clinical documentation, or utilization review experience + Five years of clinical nurse experience in an acute ... 8. Educates health team colleagues about complex clinical appeals, utilization review , including role, responsibilities tools, and...and directed. **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager Contingent Days - 2506002318 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart ... 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
- 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
- Corewell Health (Royal Oak, MI)
- …, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... all hospitalized patients. 1. 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
- Henry Ford Health System (Detroit, MI)
- …+ Proficiency with computers, electronic health records (EHR), database systems, and utilization review /case management documentation systems. + Knowledge of ... available for qualified experienced candidates with current 2 years RN Case Management in a large acute...work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- McLaren Health Care (Flint, MI)
- …services. + Two (2) years clinical nursing experience. + One (1) year previous case management or utilization review experience. **Preferred:** + BSN. + Two ... We are looking for a Case Manager, RN to join us in leading our organization...(2) years' experience in Managed Care Utilization Management , Medical Management… more
- CVS Health (MI)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
- Cognizant (Lansing, MI)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
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