- 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)
- …and work schedule may include weekends, holidays, and evening hours._ **UM Nurse Consultant** Fully Remote- WFH **Position Summary** UM Nurse Consultant ... opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external… 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)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare +… 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
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager Contingent Days - 2506002318 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart center, ... 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
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- Summary The LTC Charles S. Kettles VA Medical Center is seeking a Registered Nurse (RN) for the Patient Aligned Care Team (PACT), aligned under Ambulatory care, ... located in Ann Arbor, Michigan. The PACT Registered Nurse (RN) is responsible for providing competent, evidence-based gender-specific primary care to patients with… more