- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The Utilization Management Nurse Lead uses clinical knowledge, communication skills, and independent ... best and most appropriate treatment, care, or services for Enrollees. The Utilization Management Nurse Lead coordinates and communicates with Providers,… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Team Lead plays a key role in supporting the day-to-day operations of the UM team and serves as a liaison between frontline ... regulatory compliance. Salary: $67,000/annually JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse Team Lead's responsibilities include but are not limited… more
- CVS Health (Lansing, MI)
- …opportunities to promote quality effectiveness of Healthcare Services and benefit utilization + Consults and lends expertise to other internal and external ... constituents in the coordination and administration of the utilization /benefit management function. + Typical office working environment with productivity and… more
- CenterWell (Lansing, MI)
- …Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare/Medicaid… more
- McLaren Health Care (Pontiac, MI)
- **Department:** Utilization Management **Scheduled Bi-Weekly Hours:** 80 **Daily Work Times:** 11:00am to 7:00pm-On site **Position Summary:** Responsible for ... Utilization and Care Management services to the Emergency Center....assigned. #LI-AK1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited… more
- Corewell Health (Grand Rapids, MI)
- …continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides ... financial and utilization management information to other members of the care...patient centered care plan or related work + Registered Nurse in the State of Michigan Or Master Social… more
- Munson Healthcare (Traverse City, MI)
- …2 In the specialty area preferred. Preferred Charge Nurse experience CERTIFICATION, LICENSURE, REGISTRATION Min/Preferred Certification, Licensure, Registration ... Comments Minimum Registered Nurse in the State of Michigan. Currently Licensed OTHER...human resource data to support decision-making, which maximizes resource utilization . + Facilitates and empowers registered nurses to assume… more
- Evolent (Lansing, MI)
- …a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… more
- Evolent (Lansing, MI)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer, Nurse , you will routinely interact with leadership and management staff,… more
- Trinity Health (Grand Rapids, MI)
- …earn cash and prizes + Unlimited career growth opportunities **Position Summary:** The Nurse Navigator RN is a professional nurse who collaborates with ... the continuum and between care settings during an episode of illness. The Nurse Navigator participates in the assessment, plan, monitoring, and evaluation of the… more