- Molina Healthcare (Detroit, MI)
- …and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to… more
- CenterWell (Lansing, MI)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Lansing, MI)
- …management + Utilization management experience in a medical management review organization, such as Medicare Advantage and managed Medicaid + ... quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Molina Healthcare (Detroit, MI)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health ... assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Molina Healthcare (Warren, MI)
- …healthcare services activities for care management , care review , utilization management , transitions of care, behavioral health, long-term services ... members within Molina's clinical/healthcare services function, which may include care review , care management , and/or correspondence processing, etc. *… more
- Molina Healthcare (Sterling Heights, MI)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). **MULTI STATE / COMPACT… more
- Army National Guard Units (Lansing, MI)
- …is supervised by The Adjutant General, or 1st GO at JFHQ with the Higher-Level Reviewer being TAG. Program and case management functions are evaluated by the ... the function of this role unless delegated. This position may perform case management functions to support a temporary surge or vacancy, in coordination with the… more
- Army National Guard Units (Lansing, MI)
- …supervised by The Adjutant General , or 1st GO at JFHQ with the Higher-Level Reviewer being TAG. Program and case management functions are evaluated by the SAPR ... the function of this role unless delegated. This position may perform case management functions to support a temporary surge or vacancy, in coordination with the… more
- Sevita (Detroit, MI)
- …states to increase census, maintain occupancy, improve daily attendance, and maximize utilization . + Financial Management : + Oversee billing to ensure accuracy ... infants, children, adolescents, Military Service Members and Veterans. **Operations Management Executive Director - State of MI** **Compensation: $140,000-$160,000/year… more
- Highmark Health (Lansing, MI)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more