- Trinity Health (Farmington Hills, MI)
- …rejection, denial and appeal activities with Ministry Organization (MO) based Utilization Review /Case Management departments; + Reviews and understands ... utilization review and coverage guidelines for multiple payers; + Identifies...and reviews findings with all levels of Payment Resolution Specialist for further review . Serve as a… more
- University of Michigan (Ann Arbor, MI)
- Admin Specialist Assoc Health Apply Now **Summary** The Administrative Specialist provides comprehensive administrative support and project management for ... development. The UMHS market title for this position is Administrative Specialist Associate. **Mission Statement** Michigan Medicine improves the health of patients,… more
- Henry Ford Health System (Bingham Farms, MI)
- …of pharmacy services, decrease waste, and rework in the region, and improve drug utilization . The Pharmacy Specialist will be instrumental in guiding the further ... GENERAL SUMMARY: The Pharmacy Specialist provides oversight and leadership for appropriate drug...provided by the primary care team. He/she works with utilization management reports, corporate data stores, and information services… more
- University of Michigan (Ann Arbor, MI)
- …and prior experience working in Precertification, Coding, Health Information Management or Utilization Review is strongly desired. + Knowledge of Interqual ... Pre-Certification Specialist Apply Now **How to Apply** A cover...stay and inpatient admissions to the hospital. The precertification review process includes the application of diagnosis and procedure… more
- Chenega Corporation (Warren, MI)
- **Req ID:** 31100 **Summary** **IT Specialist ** **Warren, MI** Are you ready to enhance your skills and build your career in a rapidly evolving business climate? Are ... core culture? If so, Chenega Military, Intelligence & Operations Support (MIOS) could be the place for you! Join...in the federal IT and Training environment. The **IT Specialist ** shall perform all duties about Desktop Systems Administrations… more
- Tenet Healthcare (Detroit, MI)
- …resolve conflict. Promotes a positive customer relations environment. Coordinates the utilization review function for assigned patients. Performs periodic ... Rehab Care Coordination Specialist FT Days - 2406000956 Description : DMC...at the most appropriate level of care. Performs continuous review of services to assure patient progress and maintains… more
- Corewell Health (Royal Oak, MI)
- …the data collection and review of information gathered for drug utilization review and/or research, quality improvement monitors, adverse drug event ... non-pharmacy personnel to manage and achieve departmental/corporate objectives. Provides support for staff development so that staff meets/exceeds minimum competency… more
- Trinity Health (Farmington Hills, MI)
- …manner possible: + Coordinates follow-up activities with Utilization Review /Case Management/Coding/Nurse Liaison to provide required clinical support , as ... review . Takes initiative to continuously learn all aspects of Payment Resolution Specialist role to support progressive responsibility. Other duties as needed… more
- Ford Motor Company (Wayne, MI)
- …of maintenance operations and the direct supervision of skilled trades assigned to support production and facilities. **What you'll do ** + Ensure adherence to ... cause analysis of downtime issues to prevent recurrence (4D process) + Support / direct skilled trades/maintenance personnel to evaluate requirements for maintaining… more
- TEKsystems (Warren, MI)
- …and breaks: 8:30-5pm. 45 min Lunch. 2 x 10's. Paid breaks The case review specialist is responsible for performing all tasks relevant to in-house communications ... is supporting out of state contract health plans, support the Blue's in Michigan! 8 health plans in...that researches product and member special needs. The Case Review Specialist conducts the initial screening for… more
- Trinity Health (Livonia, MI)
- …within their region. Provides direct oversight of the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator. Working with the Regional ... directly responsible for the daily assessments of current Clinical Documentation Specialist staffing levels and processes. Ensures that defined goals are… more
- Trinity Health (Ann Arbor, MI)
- …(pre-certifications, third-party authorizations, referrals) and contacts physicians and Case Management/ Utilization Review personnel, as needed. Obtains and ... Schedules, to facilitate daily patient activity and flow in support of the clinical departments. **REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE**… more