- Corewell Health (Grand Rapids, MI)
- …Nursing experience + 5 years of Registry and/or Regulatory database management experience + LIC- Registered Nurse ( RN ) - State of Michigan upon hire Preferred ... requirement for meetings or events. We are seeking a highly skilled and detail-oriented RN Clinical Database Specialist to join our team with a primary focus on… more
- Prime Therapeutics (Lansing, MI)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5...Experience in managed care, specialty drugs, care management and utilization review . + Meets Credentialing criteria. +… more
- Evolent (Lansing, MI)
- …are applied appropriately. **Qualifications:** + Current, unrestricted state licensure as a Registered Nurse + Associate or Bachelors in Nursing (Must be ... , you will be a key member of the utilization management team. We can offer you a meaningful...a Registered Nurse ) + Strong interpersonal and communication… more
- Sharecare (Lansing, MI)
- …to enable individuals with disabilities to perform the essential functions. + Current Registered Nurse multi-state compact license in the state in which they ... utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during their interactions with participants for identification… more
- Elara Caring (Ludington, MI)
- …Identifies and reports potential payment/coverage problems. + Supervises and coordinates utilization review activities. + Participates in strategic development ... Key Accounts, including participation in weekly, monthly, and quarterly review meetings, as needed. + Ensures accuracy of all...required by state or federal guidance + Licensed physician, registered nurse or holds an undergraduate degree… more
- CVS Health (Lansing, MI)
- …visit, inpatient, skilled nursing, or rehabilitative stay. Under the direction of a Registered /Licensed RN , the TOC Coach ensures the member experiences a ... or changes in condition to be transitioned back to RN . - Complete post discharge call and required assessments...who cannot advocate for themselves. The TOC team will review prior claims to address potential impact on current… more
- US Tech Solutions (MI)
- …compliance with regulatory and accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care + Clinical ... + Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred member's needs/eligibility and determines… more
- McLaren Health Care (Petoskey, MI)
- …QUALIFICATIONS REQUIRED + Bachelor's degree in a health-related field + State license as a Registered Nurse ( RN ) + Four years of professional experience in ... equipment purchases. + Fosters smoothly running case management and utilization review services and processes through timely...RN patient care and case management and/or utilization review QUALIFICATIONS PREFERRED + Master's degree… more
- Corewell Health (Grand Rapids, MI)
- …+ 1 year of relevant experience Clinical experience in area of specialty Preferred + LIC- Registered Nurse ( RN ) - STATE_MI State of Michigan Upon Hire ... and maintenance of interdisciplinary collaborative relationships. Will provide oversight to the registered nurse and licensed practical nurse clinical… more
- Molina Healthcare (Detroit, MI)
- **Job Summary** **_For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state of KENTUCKY or have a compact license._** ... Nursing experience, including hospital acute care/medical experience (STRONGLY DESIRED)** + ** Registered Nurse with Claims and CIC coding experience (STRONGLY… more