• Organizational Quality Nurse Specialist

    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
    Hospice of Michigan (10/03/25)
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  • Healthcare Clinical Documentation Specialist

    Deloitte (Detroit, MI)
    …Bachelor's degree in nursing, medical degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical ... nurse , physician, physician assistant, case manager, clinical documentation specialist, utilization review , informatics RN , Quality, DRG Validation and… more
    Deloitte (11/21/25)
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  • NP/PA - Ctvs/General Robotic

    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
    Trinity Health (11/05/25)
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  • Medicaid Utilization Analyst 12 - HSA…

    State of Michigan (Lansing, MI)
    …requirement. Medicaid Utilization Analyst 12 Two years of experience as a Registered Nurse P11 or equivalent may be substituted for the education ... To identify psychotropic medication regimens that require additional physician review according to policy, the Utilization Reviewer...OR at least two years of experience as a Registered Nurse P11 or equivalent. If so,… more
    State of Michigan (11/20/25)
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  • Nurse Case Manager II

    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
    US Tech Solutions (10/29/25)
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  • Unit Clerk

    Behavioral Center of Michigan (Detroit, MI)
    …records for discharge/transfer. Makes appropriate copies for various departments (Nursing, Utilization Review , Billing, and Partial Hospitalization Program). + ... for the unit. Upholds system and organization in the nurse station, giving assistance to the assigned clinical staff...in log book daily lab results received. Notifies charge RN /LPN if information is missing. Lab work reports are… more
    Behavioral Center of Michigan (11/11/25)
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  • Assistant Director, Nursing

    Erickson Living (Novi, MI)
    …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... based on experience* What you will need + Current RN nursing license with no restrictions for the state...3 years' experience in a healthcare leadership role (Charge Nurse , Unit Manager, etc.). + Experience with an electronic… more
    Erickson Living (10/23/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Warren, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** *… more
    Molina Healthcare (11/21/25)
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  • RN UM Care Review Clinician Remote

    Molina Healthcare (Ann Arbor, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** *… more
    Molina Healthcare (11/13/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Sterling Heights, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
    Molina Healthcare (11/21/25)
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