- McLaren Health Care (Bay City, MI)
- **Department:** Utilization Management **Shift:** Days **Daily Work Times:** 8am - 4:30pm **Scheduled Hours per Pay:** 40 Position Summary: Responsible for ... as Assigned: 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate… more
- McLaren Health Care (Port Huron, MI)
- …as Assigned:** 1. Performs a variety of concurrent and retrospective utilization management -related reviews and functions to ensure that appropriate ... for timeliness, appropriateness and completeness as pertains to the utilization management process including level of care,...and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse (RN) ⦁ Bachelor's degree in… more
- Cognizant (Lansing, MI)
- …- Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' experience in ... 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
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- CVS Health (Lansing, MI)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… 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 + Basic Life ... of insurance prior authorizations, initial reviews, continuous stay reviews and appeals. Nurse Care Manager - Plans and prioritizes care for individuals and… 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 degree in...the Military Training network (MTN) _Preferred:_ + Experience in utilization management /case management , critical care,… 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
- CVS Health (Lansing, MI)
- …and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC (Licensed Associate ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… more
- Henry Ford Health System (Detroit, MI)
- The Certified Registered Nurse Anesthetist (CRNA) Manager is a Certified Registered Nurse Anesthetist who ensures the delivery of safe anesthetic patient ... activities in accordance with regulatory and accrediting organizations. . Hires certified registered nurse anesthetists for the department. Accepts input on… more