- Corewell Health (Dearborn, MI)
- …insurance Free onsite parking at all of our campuses Essential Functions + Utilization of a high degree of discriminative judgement while providing medical ... management including assessment of medical and psychosocial status, comprehensive...recognized PA program that is accredited by the Accreditation Review Commission on Education for Physician Assistants and meet… more
- Fresenius Medical Center (Romulus, MI)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- US Tech Solutions (MI)
- …with regulatory and accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care + Clinical practice + ... + Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred member's needs/eligibility and determines… more
- Molina Healthcare (Sterling Heights, MI)
- …3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active, ... QUALIFICATIONS** **Required Education** Any of the following: Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN)...unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE required.**… more
- University of Michigan (Ann Arbor, MI)
- …as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review on ... position is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance… more
- Molina Healthcare (Detroit, MI)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
- McLaren Health Care (Petoskey, MI)
- …for new supplies and minor equipment purchases. + Fosters smoothly running case management and utilization review services and processes through timely ... through the selection, development, training, and evaluation of case management and utilization review services...a health-related field + State license as a Registered Nurse (RN) + Four years of professional experience in… more
- Corewell Health (Royal Oak, MI)
- …discharge planning of all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or ... relevant experience Three to five years' experience in care management , utilization review , home care..., home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan License Upon Hire… more
- Corewell Health (Dearborn, MI)
- …discharge planning of all hospitalized patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or ... relevant experience Three to five years' experience in care management , utilization review , home care..., home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required… more
- Molina Healthcare (Detroit, MI)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more