- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- Summary The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined approach to receiving, triaging, and directing ... of clinical experience. Duties: The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible...intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards,… more
- Molina Healthcare (Ann Arbor, 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
- CVS Health (MI)
- …Configures the case management system to organize cases dealing with disease management and utilization review ; tracks patient progress and manages ... reimbursed per our company expense reimbursement policy **Preferred Qualifications** + Case Management experience + Compact RN licensure + Certified Case Manager… more
- McLaren Health Care (Petoskey, MI)
- …**_Preferred:_** + Associate degree in healthcare related field + Two years of case management or utilization review experience + Three years of recent ... Responsible for providing assistance to the RN and SW Care Managers in the coordination...patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure… more
- Fresenius Medical Center (Sandusky, MI)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Molina Healthcare (Warren, MI)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
- Henry Ford Health System (Detroit, MI)
- The Certified Registered Nurse Anesthetist (CRNA) Manager is a Certified Registered Nurse Anesthetist who ensures the delivery of safe anesthetic patient ... activities in accordance with regulatory and accrediting organizations. . Hires certified registered nurse anesthetists for the department. Accepts input on… more
- Trinity Health (Chelsea, MI)
- …Type:** Part time **Shift:** Rotating Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all… more
- Molina Healthcare (Ann Arbor, MI)
- …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse...Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …availability will be variable based on staffing needs. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes ... ultimately help participants live in a more independent setting. RN Shifts available for pick up are 12 hours,...assignments and promoting staff development. + Responsible for the utilization and continued review of patient care… more
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