- Tenet Healthcare (Detroit, MI)
- …at hospital and department orientation is required. Department orientation includes review and instruction regarding Tenet Case Management and Compliance ... Clinical Social Worker - Case Management - 2406003684 Description : DMC Receiving Hospital...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- Tenet Healthcare (Detroit, MI)
- …at hospital and department orientation is required. Department orientation includes review and instruction regarding Tenet Case Management and Compliance ... Clinical Social Worker Case Management Trauma Services Admin Full Time Days -...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- Tenet Healthcare (Detroit, MI)
- …at hospital and department orientation is required. Department orientation includes review and instruction regarding Tenet Case Management and Compliance ... Clinical Social Worker Case Management Full Time Days - 2506003347 Description :...patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and… more
- Elevance Health (Dearborn, MI)
- …to clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the ... means that the medical director is directly involved in Utilization Management and Case Management ....state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Sharecare (Lansing, MI)
- …change techniques, the nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is ... learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals...and to take the pre and post tests to review competency during orientation. Yearly competency tests are required… more
- Highmark Health (Lansing, MI)
- …residency program + 5 - 7 years in Pharmacy + 3 - 5 years in Pharmacist - Utilization Management + 3 - 5 years in Pharmacist - Medical Therapy Management ... to medication therapy are transitioned to a Pharmacist for Case & Disease Management (CMDM). The incumbent then conducts thorough research to evaluate the patient… more
- Highmark Health (Lansing, MI)
- …triaging members to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, ... Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or… more
- Highmark Health (Lansing, MI)
- …business relationships, the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The role involves ... executing all facets of the Informatics project management process, leading multiple project managers, and potentially guiding,...in the resolution of issues or problems. + Access, review , utilize, contribute content to and participate in the… more
- CenterWell (Lansing, MI)
- …of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care received by members in an assigned region, ... practice management . + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managedMedicaid, or… more
- CVS Health (Lansing, MI)
- …to cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and prior ... Multiple state licensure a plus. **Preferred Qualifications:** Previous Experience in Utilization Management / Claims Determination with another Health Plan… more