- 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 ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At… more
- Munson Healthcare (Traverse City, MI)
- …degree in nursing (must have RN license or social work license). If Registered Nurse , must be licensed to practice in Michigan. Also, for those hired ... skills at all times. + Maintains working knowledge/experience in utilization management , managed care, and payer issues...progress of completing complex post-acute services + Interface with utilization review specialists to stay current on… more
- University of Michigan (Ann Arbor, MI)
- …and assist in daily case management operations, including: assist with utilization management workflow and payer contacts; assist with coordination of all ... patient. + Communicate effectively with all stakeholders inclusive of Care Management staff, insurance carriers and/or their designated intermediaries, and vendors… more
- CenterWell (Portage, 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, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …are honored to be a part of this incredible work. What Will You Do?As a Lead Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes in ... patient needs and implements patient-centered, compassionate care. + Responsible for the utilization and continued review of patient care protocols, standards of… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …Pine Rest (https://www.pinerest.org/inpatient-services/services/older-adult-inpatient-services/) What Will You Do? As a Registered Nurse at Pine Rest, you'll be ... staff assignments and promoting staff development. + Responsible for the utilization and continued review of patient care protocols, standards… more
- Tenet Healthcare (Commerce Township, MI)
- …planning experience. Preferred: Acute hospital case management experience. Required: RN . Must be currently licensed, certified, or registered to practice ... RN Case Manager Clinical Res Mgmt Full Time...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- AmeriHealth Caritas (Detroit, MI)
- …required. + Bachelor of Science in Nursing preferred. + Current, active, and unrestricted Registered Nurse licensure. + 3 or more years of clinical experience at ... accurate documentation of member interactions in the electronic care management platforms. + Monitor appropriate utilization and...the bedside (as a Registered Nurse ) working with medically fragile patients… more
- Veterans Affairs, Veterans Health Administration (Saginaw, MI)
- …patient information. Completed work should need only a general review by a registered nurse ( RN ) or physician (MD/DO) for appropriateness and conformity ... Identifies and reports any patient problems based on his/her objective observations. Collaborates with the RN ( Registered Nurse ) so the RN can in… more
- Lincoln Financial (Lansing, MI)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... **What we're looking for** Education * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where… more