• Registered Nurse Utilization

    McLaren Health Care (Pontiac, MI)
    …12. Performs other duties as assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from accredited ... **Position Summary:** Responsible for Utilization and Care Management services to the Emergency...on all patients reviewed in the ED. Conducts initial review using InterQual, MCG and other tools, assists provider… more
    McLaren Health Care (08/08/25)
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  • Clinical Appeals Nurse ( RN )

    Molina Healthcare (Sterling Heights, MI)
    **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support,… more
    Molina Healthcare (08/02/25)
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  • Registered Nurse RN - Case…

    Trinity Health (Howell, 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
    Trinity Health (07/22/25)
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  • Registered Nurse , Per Diem, At Risk…

    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
    Pine Rest Christian Mental Health Services (08/09/25)
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  • Registered Nurse , 24 Hrs Weekly,…

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …Pine Rest (https://www.pinerest.org/inpatient-services/services/older-adult-inpatient-services/) What Will You Do? As a Registered Nurse at Pine Rest, you'll be ... the healing power of your expertise and compassion. An RN is responsible and accountable to perform the nursing...assignments and promoting staff development. + Responsible for the utilization and continued review of patient care… more
    Pine Rest Christian Mental Health Services (08/09/25)
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  • RN , Case Manager

    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 ... and applied criteria. Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and… more
    Trinity Health (07/31/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Type:** Part time **Shift:** Day Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** Chelsea, ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all… more
    Trinity Health (07/24/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Part time **Shift:** Rotating Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** Chelsea, ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all… more
    Trinity Health (06/04/25)
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  • Manager Case Management - McLaren Careers

    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
    McLaren Health Care (05/15/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Romulus, 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
    Fresenius Medical Center (06/28/25)
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