• Clinical Reviewer , Nurse…

    Evolent (Lansing, MI)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
    Evolent (12/10/25)
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  • New Graduate Registered Nurse

    Fresenius Medical Center (Lansing, MI)
    …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
    Fresenius Medical Center (11/19/25)
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  • Hospice Nurse Practitioner - Flex

    Gentiva (Okemos, MI)
    …(LCD) criteria per hospice policy and regulatory requirements. + Communicate clinical findings, review treatment plans, lab results, diagnostics, and ... Partnerships. Transform Hospice Care.** We are seeking a dedicated Hospice Nurse Practitioner to perform Face-to-Face (F2F) encounters essential for hospice… more
    Gentiva (11/13/25)
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  • Care Manager, Telephonic Nurse

    CenterWell (Lansing, MI)
    …complaints. + Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to ... to work every other holiday.** The **Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for...Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services +… more
    CenterWell (12/20/25)
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  • Case Manager Registered Nurse - Field…

    CVS Health (Lansing, MI)
    …outcomes as well as opportunities to enhance a member's overall wellness. + Uses clinical tools and information/data review to conduct an evaluation of member's ... all case management activities with members to evaluate the medical needs of the member to facilitate the member's...are not permitted. **Required Qualifications** + Minimum 3+ years clinical practical experience as an Registered Nurse … more
    CVS Health (12/19/25)
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  • CDQI Nurse Specialist - Part Time - Remote

    Datavant (Lansing, MI)
    …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
    Datavant (11/11/25)
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  • Registry Abstraction Nurse

    Highmark Health (Lansing, MI)
    …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient… more
    Highmark Health (12/05/25)
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  • Utilization Management Nurse

    CenterWell (Lansing, MI)
    …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
    CenterWell (11/22/25)
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  • Director of Product Management - Clinical…

    Oracle (Lansing, MI)
    …+ Excellent communication, stakeholder engagement, and leadership skills. **Preferred Qualifications:** + Clinical experience as a nurse or physician with a deep ... **Job Description** The Clinical Note AI Agent Product Management Leader will...Gather and analyze information to define product specifications and review design specifications. Envision and communicate product strategy and… more
    Oracle (12/03/25)
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  • Sr Supplier Medical Process Specialist

    Zurich NA (Lansing, MI)
    Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am experienced Sr. Supplier Medical Process Specialist to join our team in one of ... commitment to work/life balance, and outstanding culture. As a Sr. Supplier Medical Process Specialist, you will manage supplier performance and work product in… more
    Zurich NA (12/19/25)
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