- Humana (Lansing, MI)
- …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... receives guidance where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical knowledge, communication… more
- CVS Health (Lansing, MI)
- …Must have active current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area. + Managed Care experience preferred, especially Utilization Management . + Preference for those residing in EST zones.… more
- McLaren Health Care (Pontiac, MI)
- …requirements _Preferred:_ + Bachelor's degree in nursing + Experience in utilization management /case management /clinical documentation, critical care, or ... **Position Summary:** Responsible for Utilization and Care Management services to...assigned. #LI-KH1 _Required_ + State licensure as a Registered Nurse (RN) + Bachelor's degree in nursing from accredited… more
- McLaren Health Care (Petoskey, 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 maintenance of continuing education requirements **Preferred:** * Experience in utilization management /case management , critical care, or patient… more
- McLaren Health Care (Lapeer, 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_** maintenance of continuing education requirements _Preferred:_ + Experience in utilization management /case management , critical care, or patient… more
- R1 RCM (Detroit, MI)
- …encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Utilization Review Nurse ** , you will help our hospital ... you must have experience in a clinical inpatient environment and hospital-based utilization or case management experience. Proficiency in basic computer skills… more
- Trinity Health (Ann Arbor, MI)
- …clinical, age specific, developmental, cultural and spiritual needs. Facilitates utilization management documentation and appropriate communication with external ... current knowledge of rules, regulations, policies, and procedures related to utilization management work processes and criteria. + Communicates information,… more
- Humana (Lansing, MI)
- …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
- Zurich NA (Lansing, MI)
- …+ Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or ... AVP, Utilization Review & Pharmacy 123092 Zurich Insurance is...recruiting and retaining team members. + Drive the performance management process by communicating job expectations, monitoring and evaluating… more
- McLaren Health Care (Flint, MI)
- …the care provided is safe, effective, efficient, client-centered, timely and equitable. Utilization of the Case Management process includes the achievement of ... **Department** : Case Management **Daily Work Times:** 7:30am - 4:00pm **Shift:**...optimal health, access to care and appropriate utilization of resources balanced with the patient's right to… more