- Cognizant (Lansing, MI)
- …you need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- McLaren Health Care (Bay City, MI)
- …as required and directed. #LI-LM1 **Qualifications:** _Required_ + State licensure as a registered nurse (RN) + Bachelor's degree in nursing from accredited ... experience with an acute care hospital** _Preferred:_ + Experience in utilization management/case management, critical care, clinical documentation, or patient… more
- McLaren Health Care (Port Huron, MI)
- …duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse (RN) ⦁ Bachelor's degree in nursing from accredited ... experience with an acute care hospital **Preferred:** ⦁ Experience in utilization management/case management, critical care, clinical documentation, or patient… more
- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... independent determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse (RN) in the (appropriate state)… more
- Integra Partners (Troy, MI)
- …priorities, systems, and workflows in a fast-paced environment. EDUCATION: Active, unrestricted Registered Nurse , Licensed Vocational Nurse , or Licensed ... The Utilization Management (UM) Nurse Supervisor is...team performance, escalating issues as needed to the UM Clinical Manager. + Ensure compliance with all regulatory, contractual,… more
- CVS Health (Lansing, MI)
- …members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment and evidence-based criteria to ... shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum… more
- CVS Health (Lansing, MI)
- …good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult inpatient… more
- Corewell Health (Grand Rapids, MI)
- … clinical nursing and or case management/managed care or related field Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required + Basic Life ... of insurance prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals and… more
- Fresenius Medical Center (Muskegon, MI)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... FMCNA Compliance Program, and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions to ensure continuity of… more
- Fresenius Medical Center (Sandusky, MI)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more