- Evolent (Lansing, MI)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Molina Healthcare (Warren, MI)
- …will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for medical ... and cost-effective member care. **ESSENTIAL JOB DUTIES:** + Facilitates clinical / medical reviews of retrospective medical ...nursing experience, including at least 1 year of utilization review , medical claims review , long-term… more
- Fresenius Medical Center (Muskegon, MI)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… 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 ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Elara Caring (Bingham Farms, MI)
- …Care, at the Right Time, in the Right Place. **Job Description:** **Licensed Practical Nurse Clinical Coordinator** At Elara Caring, we care where you are and ... ways to make a difference as a Licensed Practical Nurse Clinical Coordinator. Being a part of...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
- Advanced Correctional Healthcare (Jackson, MI)
- Clinical Nurse Educator - RN / Michigan Job... Review and follow up with 30, 60, 90 nurse onboarding + Collaborate with the Provider educator to find ... Details Job Location Clinical Nurse Educator - RN / Michigan...Insurance SUMMARY: Our associates deliver a higher standard of medical care, mental health care, and business services. We… more
- AccentCare, Inc. (Madison Heights, MI)
- Overview Registered Nurse / RN Team Director , Hospice Location: Madison Heights, MI Position: Registered Nurse / RN Team Director Job ID: 2025-71995 ... Area: Madison Heights Find Your Passion and Purpose as a Full-Time Hospice Registered Nurse / RN Team Director Salary: $95000 - $105000 / annually Schedule: MON-FRI… more
- Elara Caring (Ludington, MI)
- …Care, at the Right Time, in the Right Place. **Job Description:** **Licensed Practical Nurse LPN Clinical Coordinator Home Health** At Elara Caring, we care ... countless ways to make a difference as a **LPN Clinical Coordinator.** Being a part of something this great...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
- Elevance Health (Dearborn, MI)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Clinical Fraud Investigator II** is responsible… more
- Humana (Lansing, MI)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more