• Utilization Rev Appeals Spec

    University of Michigan (Ann Arbor, MI)
    Utilization Rev Appeals Spec Apply Now **Job Summary** **Why Join Michigan Medicine's Hospital Billing Audits & Appeals (HBAA) Department?** The Audit and Appeals ... Registration, MiVisit Business services, clinics and ancillary departments. + Review patient medical records and utilize clinical and regulatory knowledge… more
    University of Michigan (10/25/25)
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  • Staff Physician - Interventional Radiology

    Veterans Affairs, Veterans Health Administration (Detroit, MI)
    …and peer review . Participates and facilitates implementation of modern care, utilization of new technologies and new procedures. This includes but is not limited ... by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA offers a comprehensive total rewards… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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  • Physician Assistant/Nurse Practitioner (C),…

    Corewell Health (Royal Oak, MI)
    …Graduate of AMA recognized PA program that is accredited by the Accreditation Review Commission on Education for Physician Assistants and meet requirements of ... Job Summary Physician Assistants (PA) are graduates of an accredited...signature. Reports to Manager APP PA. Essential Functions + Utilization of a high degree of discriminative judgement while… more
    Corewell Health (10/29/25)
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  • Physician Assistant/Nurse Practitioner (D),…

    Corewell Health (Dearborn, MI)
    …Graduate of AMA recognized PA program that is accredited by the Accreditation Review Commission on Education for Physician Assistants and meet requirements of ... you join our team at Corewell Health. Full-time, Day Shift Job Summary Physician Assistants (PA) are graduates of an accredited educational program and are… more
    Corewell Health (10/03/25)
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  • Physician Advisor

    R1 RCM (Detroit, MI)
    …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Physician Advisor** , you will help our client facilities navigate the ... to compliant revenue by reviewing payor peer-to-peer cases. Every day you will review cases for which authorization has been denied evaluating if the proper… more
    R1 RCM (10/24/25)
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  • Medical Director, Medical Management

    Highmark Health (Lansing, MI)
    …DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the multidisciplinary team ... Inc. **Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in… more
    Highmark Health (10/28/25)
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  • Care Review Processor (Remote) PST Hours

    Molina Healthcare (Detroit, MI)
    JOB DESCRIPTION Job SummaryProvides non-clinical administrative support to utilization management team and contributes to interdisciplinary efforts supporting ... * Provides telephone, clerical and data entry support for the care review team. * Provides computer entries of authorization request/provider inquiries, such as… more
    Molina Healthcare (10/09/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
    Corewell Health (10/23/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). + ... years of relevant experience Three to five years' experience in care management, utilization review , home care and/or discharge planning. Preferred + Registered… more
    Corewell Health (10/17/25)
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  • Registered Nurse (RN) - Case Manager

    Tenet Healthcare (Detroit, MI)
    …level of care based on Medical Necessity process and submits case for Secondary Physician review per Tenet policy. Ensures timely communication of clinical data ... the following activities: a) accurate medical necessity screening and submission for Physician Advisor review , b) care coordination, c) transition planning… more
    Tenet Healthcare (10/23/25)
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