- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm **Hours Per Pay Period:** 40 **Position Summary:** Responsible for determining the… more
- McLaren Health Care (Bay City, MI)
- …duties as required and directed. #LI-LM1 **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... accordance with established SOP procedures. 8. Maintains current knowledge of hospital utilization review processes and participates in the resolution of… more
- Henry Ford Health System (Warren, 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 (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Sterling Heights, MI)
- …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
- Molina Healthcare (MI)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
- Corewell Health (Dearborn, MI)
- …care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). +… more
- McLaren Health Care (Grand Blanc, MI)
- …, including role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from ... years of recent denial management, case management, clinical documentation, or utilization review experience + Five years of clinical nurse experience in an… 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
- CVS Health (Lansing, MI)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
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