- Integra Partners (Troy, MI)
- …experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key ... UM program. Salary: $60,000.00/annual JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The UM Nurse 's responsibilities include but are not limited to: + Perform… more
- McLaren Health Care (Port Huron, MI)
- **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the appropriate ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management-related reviews and functions to ensure that appropriate data are… more
- McLaren Health Care (Flint, MI)
- …help people live healthier and more satisfying lives. We are looking for a Utilization Management RN, to join in leading the organization forward. MHP is a Managed ... to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to review and… more
- Cognizant (Lansing, MI)
- …background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience in ... to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical… more
- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case Management - 2506004107 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse (RN) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered Nurse with ... patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patients resources and...experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan. 4. Accredited Case… more
- CVS Health (Lansing, MI)
- …do it all with heart, each and every day. Drives effective utilization management practices by ensuring appropriate and cost-effective allocation of healthcare ... and facilitating appropriate healthcare services/benefits for members. Conducts routine utilization reviews and assessments, applying evidence-based criteria and clinical… more
- Molina Healthcare (Sterling Heights, MI)
- …key health care services (HCS) functions: care management, care transitions, utilization management, behavioral health and/or nurse advice line. Demonstrates ... services professionals, in some or all of the following functions: utilization management, care management, care transitions, behavioral health, long-term services… more
- Munson Healthcare (Traverse City, MI)
- …Traits? . Compassion . Communication . Attention To Detail . Patience Becoming a nurse in our orthopedic department is a fulfilling and demanding career that allows ... for details about Munson Healthcare benefits! Requirements + Must hold a current Registered Nurse license in the State of Michigan. + 2 Years Relevant Experience +… more
- Veterans Affairs, Veterans Health Administration (Detroit, MI)
- …of complex client care. The Emergency Department (ED) Registered Nurse (RN) executes position responsibilities that demonstrate leadership, experience, and ... plan as necessary. VA offers a comprehensive total rewards package: VA Nurse Total Rewards Pay: Competitive salary, regular salary increases, potential for… more