- Molina Healthcare (MI)
- …abuse through the identification of aberrant coding and/or billing patterns through utilization review . * Incorporate leadership and communication skills to work ... care experience. **REQUIRED LICENSE, CERTIFICATION, ASSOCIATION** : Active, unrestricted State Registered Nursing ( RN ) license in good standing. **PREFERRED… more
- Sedgwick (Lansing, MI)
- …to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines; and to ... provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the provision of these… more
- McLaren Health Care (Mount Clemens, MI)
- …* Associate degree in healthcare-related field * Two years of case management or utilization review experience * Three years of recent experience doing third ... Day shift, 8am-430pm **Position Summary:** Responsible for providing assistance to the RN and SW Care Managers in the coordination of discharge and transition… more
- McLaren Health Care (Petoskey, MI)
- …degree in coding/medical records/billing or UM * Two years of case management or utilization review experience * Three years of recent experience doing third ... pay period:** **Schedule:** **Position Summary:** Responsible for providing assistance to the RN and SW Care Managers in the coordination of discharge and transition… more
- Hospice of Michigan (Southfield, MI)
- …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical… more
- Highmark Health (Lansing, MI)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective ** utilization management** strategies including: review of appropriateness of health ... care services, application of criteria to ensure appropriate resource utilization , identification of opportunities for referral to a Health Coach/case management,… more
- Lincoln Financial (Lansing, MI)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like… more
- Trinity Health (Ann Arbor, MI)
- …managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the ... Practitioner Program with emphasis on area of certification/licensure. **NP Licensure** : Current Registered Nurse and Acute Care Nurse Practitioner license… more
- US Tech Solutions (MI)
- …compliance with regulatory and accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care + Clinical ... + Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred member's needs/eligibility and determines… more
- McLaren Health Care (Port Huron, MI)
- …Associates degree in healthcare related field. + Two years of case management or utilization review experience * Three years of recent experience doing third ... **Position Summary:** Responsible for providing assistance to the RN and SW Care Managers in the coordination...**Essential Functions and Responsibilities** **as Assigned** **:** 1. Assists RN and SW Care Managers with the referral process… more