- Henry Ford Health System (Troy, MI)
- The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution ... Additional Information + Organization: Corporate Services + Department: Central Utilization Mgt + Shift: Day Job + Union Code:...team members is our priority. That's why we offer support in the various components of our team's well-being:… more
- Integra Partners (Troy, MI)
- …processes for UM and Credentialing, including planning, execution, data validation, documentation review , and reporting of findings. + Support external audits as ... The Quality & Accreditation Specialist is responsible for coordinating and maintaining accreditation activities for the Utilization Management (UM) and… more
- Molina Healthcare (Sterling Heights, MI)
- …candidate with a RN licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review experience. Knowledge in ... DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that...the specific programs supported by the plan such as utilization review , medical claims review ,… more