• RN Case Manager

    Trinity Health (Livonia, MI)
    …and applied criteria. Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and ... accrediting agency standards and regulations relative to utilization review . **BENEFITS AVAILABLE TO YOU AS...Insurance, Short and Long-term Disability starts DAY ONE + Nurse Residency Program for all new nurses! Click here… more
    Trinity Health (11/08/25)
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  • Director - Case Management

    Tenet Healthcare (Detroit, MI)
    …provisions and provides interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for and drafts or defines ... to ensure timely referral, follow up and documentation. Implements and monitors utilization review process in place to communicate appropriate clinical data to… more
    Tenet Healthcare (12/02/25)
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  • Nurse

    Veterans Affairs, Veterans Health Administration (Adrian, MI)
    Summary The LTC Charles S. Kettles VA Medical Center is seeking a Full-Time Registered Nurse ( RN ) to serve as the Patient Aligned Care Team (PACT) Outpatient ... Staff Registered Nurse ( RN ) for the...education, orientation, competencies and providing quality improvement and outcomes utilization . Demonstrates leadership in delivering and improving holistic, primary… more
    Veterans Affairs, Veterans Health Administration (12/13/25)
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  • Healthcare Clinical Documentation Specialist

    Deloitte (Detroit, MI)
    …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN , Quality, DRG Validation and… more
    Deloitte (11/21/25)
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  • Psych Graduate Nurse , At Risk Youth…

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …workplace. Principal Duties and Responsibilities: + Works in collaboration with an unrestricted Registered Nurse to provide care to person's served in a dyad ... 90-180 days. What Will You Do? As a Graduate Nurse ( RN ) at Pine Rest, you'll be...person's served centered, compassionate care. + Responsible for the utilization and continued review of patient care… more
    Pine Rest Christian Mental Health Services (10/25/25)
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  • Denials Prevention Specialist, Clinician PRN

    Datavant (Lansing, MI)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
    Datavant (11/12/25)
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  • Nurse Manager- Plastic and Reconstructive…

    Henry Ford Health System (Detroit, MI)
    GENERAL SUMMARY: The Nursing Manager is a Registered Nurse who is accountable for leading, managing, developing, supervising, and evaluating the delivery of ... REQUIRED: Current licensure by the Michigan State Board of Nursing as a Registered Nurse . Current BLS or ACLS per Henry Ford Health policy.… more
    Henry Ford Health System (11/15/25)
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  • Director (Cell and Gene Therapy Program)

    University of Michigan (Ann Arbor, MI)
    …Professional Licensure + Active licensure in the State of Michigan as a Registered Nurse , Pharmacist, or relevant clinical specialty. Education + Bachelor's ... advanced therapies such as Cell and Gene Therapy. Certifications/Licensure (Preferred) + Registered Nurse (Michigan Board of Nursing) + Licensed Pharmacist… more
    University of Michigan (12/09/25)
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  • Payment Integrity Clinician

    Highmark Health (Lansing, MI)
    …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
    Highmark Health (11/14/25)
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  • Organizational Quality Nurse Specialist

    Hospice of Michigan (Ann Arbor, MI)
    …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical… more
    Hospice of Michigan (12/10/25)
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