- 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 ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- CVS Health (Lansing, MI)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… 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 + ... Thursday, Friday (4 hours), mostly remote, occasional on-site About the Department: RN UM - Supporting the insurance coordination functions for the Helen DeVos… more
- CenterWell (Lansing, MI)
- … RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous… more
- McLaren Health Care (Pontiac, MI)
- …barriers to D/C). 4. Identifies unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. ... and directed. #LI-AK1 _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's...the Military Training network (MTN) _Preferred:_ + Experience in utilization management /case management , critical care,… more
- McLaren Health Care (Bay City, MI)
- …duties as required and directed. #LI-LM1 **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... **Department:** Utilization Management **Shift:** Days **Daily Work Times:** 8am - 4:30pm **Scheduled Hours per Pay:** 40 Position Summary: Responsible for… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- Cognizant (Lansing, MI)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... 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
- Tenet Healthcare (Detroit, MI)
- Registered Nurse Case Manager ( RN ) - 2506003132 Description : DMC Detroit Receiving Hospital , Michigan's first Level I Trauma Center, helped pioneer the ... for case management scope of services including: Utilization Management supporting medical necessity and denial... experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Trinity Health (Ann Arbor, MI)
- …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more