- Trinity Health (Chelsea, MI)
- …population through the use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all members of the health ... **Employment Type:** Part time **Shift:** Day Shift **Description:** **Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:**… more
- Trinity Health (Chelsea, MI)
- …population through the use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all members of the health ... **Employment Type:** Part time **Shift:** Rotating Shift **Description:** **Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:**… more
- Sedgwick (Lansing, MI)
- …narcotic use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, ... assessment with service provider. + Calls treating physicians to conduct a peer review of medications used on specific claims and provides insight for drug… more
- Corewell Health (Royal Oak, MI)
- …and implementation performance evaluations, OPPE/FPPE, etc. Represents APPs to outside review services such as Joint Commission, American College of Surgeons etc. ... reviewing billing practices and monitoring metrics such as reimbursement, productivity, and utilization . + Act as central oversight for CE/CME policy including … more
- Erickson Living (Novi, MI)
- …leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee ... indicators/benchmarking such as Falls, Pressure Ulcers, Medication Errors, Restraint Utilization , Re-hospitalization, Anti-psychotic utilization , ADL splits/documentation, etc.… more
- Humana (Lansing, MI)
- …and leadership during Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy ... maintain medical coverage policies utilizing an evidence based medicine review process. **Location:** work at home anywhere Humana is...any field or equivalent experience + Active unrestricted Registered Nurse (RN) license + 5 years or more of… more
- Trinity Health (Ann Arbor, MI)
- …managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the ... Education** : Master's Degree in clinical nursing from an accredited Nurse Practitioner Program with emphasis on area of certification/licensure. **NP Licensure**… more
- Corewell Health (Grand Rapids, MI)
- …of interdisciplinary collaborative relationships. Will provide oversight to the registered nurse and licensed practical nurse clinical practices. Will ... that support patient care delivery in assigned area. This includes effective utilization of workforce, facilities and equipment. Provides feedback to leadership on… more
- Trinity Health (Howell, MI)
- …managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the ... Education** : Master's Degree in clinical nursing from an accredited Nurse Practitioner Program with emphasis on area of certification/licensure. **NP Licensure**… more
- Prime Healthcare (Port Huron, MI)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses ... and assessment and evaluation of data/statistics obtained from an on-going review process. 5. Experience and knowledge in basic to intermediate computer… more