- Humana (Lansing, MI)
- …where your clinical expertise and passion for accuracy will make a meaningful impact. As the Nurse Audit Manager , you will spearhead audit and validation ... relevant coding. + Identifies the root cause analysis of audit findings and submits recommendations for appropriate change management....skills to make an impact** **Required Qualifications** + Registered nurse (RN). + 5 or more years of clinical… more
- Integra Partners (Troy, MI)
- The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team ... leadership duties, serving as both a mentor and performance manager for frontline staff. Salary: $75,000.00/Annually JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES… more
- Molina Healthcare (Warren, MI)
- …**PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional ... to clinical experience + Documents clinical review summaries, bill audit findings and audit details in the database + Provides supporting documentation for… more
- Molina Healthcare (Sterling Heights, MI)
- …following: + Active and unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare ... outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse (RN) performs clinical/medical reviews of previously denied cases… more
- CVS Health (Lansing, MI)
- …travel if a plan sponsor requests pharmacist attendance for an onsite visit/assessment/ audit . The Pharmacy Program Manager role includes: -Collaborate with an ... with heart, each and every day. The Pharmacy Program Manager is an individual contributor (non-people manager )...interdisciplinary care management team ( nurse case managers, medical directors, dietitians, social workers) to… more
- Tenet Healthcare (Detroit, MI)
- Manager of Patient Services Med Surg Telemetry Full Time Days - 2506003229 Description : DMC Harper University Hospital has distinguished itself in surgery and ... and/or high-level professional/administrative exempt and Nursing supervisory personnel. The Manager Patient Services positions with patient care accountability, plan,… more
- Tenet Healthcare (Detroit, MI)
- Manager Patient Services Telemetry Full Time Days - 2506002938 Description : DMC Sinai-Grace Hospital is DMC's largest hospital, offering a comprehensive heart ... and/or high-level professional/administrative exempt and Nursing supervisory personnel. The Manager Patient Services positions with patient care accountability, plan,… more
- Tenet Healthcare (Detroit, MI)
- Manager of Patient Services SCI Full Time Rotate - 2506003010 Description : DMC Rehabilitation Institute of Michigan is one of the nation's largest hospitals ... and/or high-level professional/administrative exempt and Nursing supervisory personnel. The Manager Patient Services positions with patient care accountability, plan,… more
- Tenet Healthcare (Detroit, MI)
- Manager Patient Services Pediatric ICU Full Time Days - 2506002852 Description : Children's Hospital of Michiga n is an international leader in pediatric and ... and/or high-level professional/administrative exempt and Nursing supervisory personnel. The Manager Patient Services positions with patient care accountability, plan,… more
- Elevance Health (Dearborn, MI)
- …coding principles, clinical guidelines, and objectivity in the performance of medical audit activities. + Draws on advanced ICD-10 coding expertise, mastery of ... clinical guidelines, and industry knowledge to substantiate conclusions. + Utilizes audit tools, auditing workflow systems and reference information to generate … more
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