- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Molina Healthcare (Sterling Heights, MI)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... state, and local laws and regulatory requirements affecting the medical and clinical staff. + Marketplace UM ...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (Detroit, MI)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- University of Michigan (Ann Arbor, MI)
- …regional, national , and international referrals. PCTU specializes in the medical and surgical care of infants, children, adolescents, and adults with congenital ... CLINICAL NURSING DIRECTOR (CS Mott Children's Hospital: 10-West Pediatric Cardiothoracic...world and has been the site of many groundbreaking medical and technological advancements since the opening of the… more
- Integra Partners (Troy, MI)
- …policies). + Review and process clinical and administrative appeals; coordinate with Medical Director when required. + Generate and review daily/weekly reporting ... The Utilization Management ( UM ) Nurse Supervisor is responsible for providing direct...Story Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic… more
- Corewell Health (Grand Rapids, MI)
- …Priority Health - 1231 E Beltline - Grand Rapids Department Name PH - Executive Medical Director Employment Type Full time Shift Day (United States of America) ... Medical Management and Rx Operations, including credentialing, formularies, UM /CM, member engagement, policy development / alignment / synchronization. + Partner… more
- Evolent (Lansing, MI)
- …Tasks are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, ... that do not meet established clinical criteria to the Medical Director . + Appropriately identifies and refers.... + Appropriately identifies and refers quality issues to UM Leadership. + Appropriately identifies potential cases for Care… more
- University of Michigan (Ann Arbor, MI)
- …care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School ... a competitive salary with excellent benefits!** The benefit package includes: + Excellent medical , dental and vision coverage + 2:1 Match on retirement savings and… more
- University of Michigan (Ann Arbor, MI)
- …Administrator, with dotted line reporting to CHAMPPS leadership and the MCHC Outreach Director . In addition, this role will have a working relationship with the MCHC ... Co-Directors, the Executive Director of CS Mott Children's Hospital, the Clinical Department...world and has been the site of many groundbreaking medical and technological advancements since the opening of the… more
- University of Michigan (Ann Arbor, MI)
- …care complexes in the world and has been the site of many groundbreaking medical and technological advancements since the opening of the U-M Medical School ... **What Benefits can you Look Forward to?** + Excellent medical , dental and vision coverage effective on your very...the Clinical Nursing Directors on the unit and with Director of Quality and Safety. The CNS coordinates and… more
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