- Integra Partners (Troy, MI)
- …as operational needs require. The Senior MD provides clinical oversight to the Utilization Review Medical Director (s), ensures consistent application ... Integra's clinical position to internal and external stakeholders. The Senior Utilization Review Medical Director 's responsibilities include but are… more
- Integra Partners (Troy, MI)
- The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to ... and are committed to consistency, compliance, and evidence-based decision making. The Utilization Review Medical Director 's responsibilities include but… more
- Behavioral Center of Michigan (Warren, MI)
- Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart...all tasks requested by the UR Manager, CEO or Medical Director to meet the needs of… more
- Integra Partners (Troy, MI)
- The UM Coordinator assists and supports the clinical team (UM Nurses/ Medical Director ) with administrative and non-clinical tasks related to processing ... Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES +...RESPONSIBILITIES + Monitor incoming faxes + Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS… more
- Molina Healthcare (Detroit, MI)
- …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... utilization . * Educates and interacts with network, group providers and medical managers regarding utilization practices, guideline usage, pharmacy … more
- Tenet Healthcare (Detroit, MI)
- …using data to drive hospital utilization performance improvement, c) ensures medical necessity review processes are completed accurately and in compliance ... Director - Case Management - 2506004210 Description :...Utilization Management Implements and monitors processes to ensure medical necessity review processes are in place… more
- Molina Healthcare (Detroit, MI)
- …reviews behavioral health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education ... programs and chemical dependency services - working closely with regional medical directors to standardize behavioral health utilization management policies… more
- Elevance Health (Dearborn, MI)
- …unless an accommodation is granted as required by law. The ** Medical Director -Dermatology Appeals** is responsible for the review of appeals for physical ... ** Medical Director -Dermatology Appeals** **Location:** This role...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Sevita (Detroit, MI)
- …adolescents, Military Service Members and Veterans. **Operations Management Executive Director - State of MI** **Compensation: $140,000-$160,000/year with an ... skills to a team-based workplace that puts people first. As Executive Director of Operations Management, you will be responsible for operational management at… more
- Molina Healthcare (Detroit, MI)
- …practice experience, and at least 2 years as a medical director in managed care setting supporting utilization management/quality management initiatives, or ... care team (ICT) activities. * Recruits, hires, trains, mentors and develops medical director staff as needed. * Ensures that authorization decisions… more
- University of Michigan (Ann Arbor, MI)
- …+ Work in partnership with Head Orthopedic Team Physician for UM Athletics and Medical Director for UM Athletics to assure excellent access and best practices ... Associate Director , Sports Medicine Apply Now **Job Summary** Leadership...experience, increasing the efficiency of system capacity and resource utilization , and growing the clinical enterprise. Connect back to… more
- University of Michigan (Ann Arbor, MI)
- Administrative Director - Michigan Congenital Heart Center Apply Now **How to Apply** A cover letter is required for consideration for this position and should be ... that directly relate to this position. **Job Summary** The Administrative Director will have oversight and responsibility for strategic planning, operations and… more
- Arrow Electronics (Plymouth, MI)
- **Position:** Sales Engineering Director - Cloud, Data/AI **Job Description:** **The start date for this position is estimated to be in January 2026.** Arrow is ... seeking a Sales Engineering Director (SED) to provide strategy, technical direction and business...product and proof of concept demonstrations, solution consultation, architecture review , and enablement of Arrow partners. The SED possesses… more
- Erickson Living (Novi, MI)
- …and dehydration. + Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management/Safety (PI/RM/S) ... Erickson Senior Living Join our team as the Assistant Director of Nursing is responsible for clinical leadership and...which builds on our mission, vision and values + Medical , dental and vision packages, including an annual reimbursement… more
- Trinity Health (Ann Arbor, MI)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Regional Director , Laboratory Sales and Outreach** **Drive the growth and success of our ... business metrics** , including sales performance, lost accounts, and resource utilization (eg, phlebotomy site productivity). + **Plan short- and long-term… more
- Corewell Health (Royal Oak, MI)
- …patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2. ... status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff. 5.… more
- Trinity Health (Auburn Hills, MI)
- …care and education under the supervision of the Sleep Lab Manager and the Medical Director and consistent with standards established by the Association of ... Polysomnographic Technology. Record review and scoring of polysomnograms is an integral part...Ensure equipment is properly prepared for patient testing and utilization . 1. Prepare and calibrate equipment required for testing.… more
- Integra Partners (Troy, MI)
- …accreditation standards and achieve high-quality outcomes. The position will report to the Director of Medical Management and work closely with other departments ... responsible for coordinating and maintaining accreditation activities for the Utilization Management (UM) and Credentialing departments. This includes supporting… more
- Trinity Health (Livonia, MI)
- …in their defined region and day-to-day management of the CDI programs. Works with Director , CDI to ensure the program is in alignment with the Trinity Health CDI ... specialists (CDS) to enhance clinical and coding skill sets and optimal utilization of 3M CDI software. Analyzes data to determine educational opportunities and… more
- Behavioral Center of Michigan (Detroit, MI)
- …records for discharge/transfer. Makes appropriate copies for various departments (Nursing, Utilization Review , Billing, and Partial Hospitalization Program). + ... setting. Meets the communication needs of the patient/family, departmental staff and medical staff. Prepares and compiles records for the unit. Upholds system and… more