- Corewell Health (Royal Oak, MI)
- …for groups of patients as it relates to disease management, resource utilization , access, discharge planning, quality, service and efficiently across the continuum. ... focus. Scope of work Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient.… more
- Corewell Health (Dearborn, MI)
- …weekend Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. ... care and cost effectiveness through the integration and functions of utilization management, and/or care coordination, discharge planning, and appropriate care… more
- Munson Healthcare (Traverse City, MI)
- REQUIREMENTS: Registered Nurse in the State of Michigan. Minimum of 2 years of relevant experience, 2 years in the specialty area preferred. A BSN is required for ... those hired into the role after October 1, 2018. Charge Nurse experience preferred Demonstrates exceptional professional role model behavior that supports… more
- University of Michigan (Ann Arbor, MI)
- …is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance between individual ... clinical needs with the efficient and cost effective utilization of resources while promoting quality outcomes. **Organizational Relationships** The RN Case Manager… more
- Molina Healthcare (Grand Rapids, MI)
- …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- Munson Healthcare (Traverse City, MI)
- ENTRY REQUIREMENTS Current license as a Registered Nurse in the State of Michigan. Minimum of 2 years of relevant experience, 2 years in the specialty area ... Educational Requirements: - BSN to be obtained in 5 years Charge Nurse experience preferred. Demonstrates exceptional professional role model behavior that supports… more
- Munson Healthcare (Gaylord, MI)
- …other departments/units within the hospital. Minimum Requirements: Current license as a Registered Nurse in the State of Michigan. Minimum of 2 years of relevant ... experience, 2 years in the specialty area preferred. Charge Nurse experience preferred. BSN preferred. ADN required + BSN in 5 years upon hire. Demonstrates… more
- Humana (Lansing, MI)
- …for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million Medicare members. You will also facilitate ... The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director team to… more
- McLaren Health Care (Petoskey, MI)
- …and minor equipment purchases. + Fosters smoothly running case management and utilization review services and processes through timely and effective resolution of ... the selection, development, training, and evaluation of case management and utilization review services staff. + Maintains professional and technical knowledge by… more
- Henry Ford Health System (Troy, MI)
- …Plan (HAP) is looking to grow our Medical Appeals Team with an experienced Registered Nurse ! We are a team of Registered Nurses (3 and counting) and Utilization ... investigating Provider Appeal requests and Code Review inquiries for all Utilization Management divisions, including delegated entities. + Summarize outcome of… more