- 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)
- …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
- McLaren Health Care (Port Huron, MI)
- …7:00PM-7:30AM **Scheduled Bi-Weekly Hours:** 72 **Position Summary:** The Registered Nurse delivers quality nursing care through the utilization of the ... and verbal communication. + Participates in the resident care review process and assists in establishing resident goals, problem...+ Associates degree from an accredited university + Valid RN licensure from the State of Michigan + CPR… more
- State of Michigan (Lansing, MI)
- …regimens that require additional physician review according to policy, the Utilization Reviewer actively monitors Medicaid claims data. Cases identified are ... prepared and assigned by the Utilization Reviewer to the MDHHS psychiatrist performing... Analyst 12 Two years of experience as a Registered Nurse P11 or equivalent may be… more
- CVS Health (Lansing, MI)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant,...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review or… more
- CVS Health (Lansing, MI)
- …of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment to… more
- Molina Healthcare (Grand Rapids, MI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical...our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The… more
- University of Michigan (Ann Arbor, MI)
- Utilization Rev Appeals Spec Apply Now **Job Summary** **Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals ... Registration, MiVisit Business services, clinics and ancillary departments. + Review patient medical records and utilize clinical and regulatory knowledge… more
- Molina Healthcare (Grand Rapids, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- CenterWell (Lansing, MI)
- …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
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