• RN Utilization Review

    Tenet Healthcare (Detroit, MI)
    RN Utilization Review Full Time Days - 2506001796 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...Conditions of Participation and Tenet policies Operates within the RN scope of practice as defined by state licensing… more
    Tenet Healthcare (07/31/25)
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  • Registered Nurse RN - Case…

    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 ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE**...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
    Trinity Health (06/24/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Romulus, MI)
    …all FMS manuals. + Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic, paper or voice mail, ... supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve… more
    Fresenius Medical Center (06/28/25)
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  • Registered Nurse Case Manager…

    Henry Ford Health System (Detroit, MI)
    …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a valid, unrestricted State of Michigan… more
    Henry Ford Health System (07/10/25)
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  • Case Manager Registered Nurse

    CVS Health (Lansing, MI)
    …care. + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience ... in a hospital setting. + A Registered Nurse that holds an active, unrestricted...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC… more
    CVS Health (07/31/25)
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  • Registered Nurse , Case Manager…

    CVS Health (Lansing, MI)
    …care - Perform medical necessity reviews **Required Qualifications** - 5+ years' experience as a Registered Nurse ( RN ) with at least 1 year of experience in ... a hospital setting - A Registered Nurse that holds an active, unrestricted...lower levels of care - 1+ years' experience in Utilization Review - CCM and/or other URAC… more
    CVS Health (07/31/25)
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  • Utilization Management Nurse

    CVS Health (Lansing, MI)
    …and administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management/ review experience preferred Outpatient Clinical experience. + Knowledge of… more
    CVS Health (07/26/25)
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  • Utilization Management Nurse

    CVS Health (Lansing, MI)
    …care **Preferred Qualifications** + NICU experience highly preferred + Managed care/ utilization review experience + Ability to multitask, prioritize and ... opportunities to promote quality effectiveness of healthcare services and benefit utilization . **Required Qualifications** + Active and unrestricted RN licensure… more
    CVS Health (07/23/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
    Corewell Health (06/27/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Type:** Part time **Shift:** Day Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** Chelsea, ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all… more
    Trinity Health (07/24/25)
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