- 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: University Hospital (Care Management) Apply...+ Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management**… more
- Cognizant (Lansing, MI)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- CenterWell (Grand Rapids, MI)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager ( RN ) - 2506003132 Description : DMC Detroit Receiving Hospital , Michigan's first Level I Trauma Center, helped pioneer the ... Rosa Parks Geriatric Center of Excellence. Job Summary The RN Case Manager is responsible to facilitate care along...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Trinity Health (Ann Arbor, MI)
- …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
- Pine Rest Christian Mental Health Services (Grand Rapids, MI)
- …availability will be variable based on staffing needs. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes ... ultimately help participants live in a more independent setting. RN Shifts available for pick up are 12 hours,...assignments and promoting staff development. + Responsible for the utilization and continued review of patient care… more
- Molina Healthcare (MI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- McLaren Health Care (Flint, MI)
- …organizational goals. Assumes responsibility for the clinical administrative aspects of utilization review and case management. Integrates medical management ... as well as documentation of the case management and utilization management processes. Responsible to collaborate in the delivery...in Nursing, health care or business-related field + Valid RN License in state doing business in + Ten… more
- Trinity Health (Livonia, MI)
- …clinical experience in nursing and recent (within 2 year) experience in utilization review /management/discharge planning or case management. Current knowledge of ... criteria. Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of...Insurance, Short and Long-term Disability starts DAY ONE + Nurse Residency Program for all new nurses! Click here… more
- Fresenius Medical Center (Muskegon, MI)
- …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more