- Tenet Healthcare (Detroit, MI)
- …care options May, if licensed RN , oversee work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator. (10% daily, essential) Compliance ... Group Director Utilization Review - 2506000536 Description :...(CPA) preferred, Six Sigma Green Belt preferred · Valid Registered Nurse ( RN ) preferred PHYSICAL… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our ... position. **Here's what you will experience working as a Utilization Review Nurse :** + Perform...ten-hour shifts Friday to Monday. **Required Skills:** + Active Registered Nurse ( RN ) license in… more
- Trinity Health (Ann Arbor, MI)
- …Part time **Shift:** Day Shift **Description:** **POSITION PURPOSE** + The Utilization Review Specialist is a Registered Nurse that is responsible for ... clinically relevant knowledge regarding patient population. + Licensure: Current Registered Nurse license in the State of Michigan ( RN ). **POSITION BENEFITS… more
- Henry Ford Health System (Troy, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State of Michigan License.… more
- Molina Healthcare (MI)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... acute care/medical experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must… more
- Molina Healthcare (Grand Rapids, MI)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... state/federal regulations **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION:** Active, unrestricted State Registered Nursing ( RN ) license in good standing.… more
- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in United States who has a compact, multi-state license. This team reviews the prior ... for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of… more
- Corewell Health (Farmington Hills, MI)
- …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a valid, unrestricted State of Michigan… more
- University of Michigan (Ann Arbor, MI)
- …position is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a balance ... RN CASE MANAGER: (Care Management- D. Dan and...+ Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management**… more