- 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
- 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 (Sterling Heights, 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
- 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
- Tenet Healthcare (Detroit, MI)
- …the development of clinical services, the provision of quality patient care and the medical staff peer review process. Works collaboratively with the DMC Chief ... Clinical Quality Improvement Director - 2506003005 Description : DMC Sinai-Grace Hospital...and in conjunction with the DMC Chief Quality and Medical Safety Officer, provides leadership for the development and… 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
- Common Ground (Bingham Farms, MI)
- …a unique combination of customer service, crisis intervention, resource guidance, utilization review , mobile crisis oversite and dispatch, Behavioral Health ... to explore mental health concerns and/or connection to a medical practitioner for a short-term bridge prescription until an...Common Ground. To learn more about this position, please review the job description: Common Ground Crisis Hub -… 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
- Elara Caring (Rochester Hills, MI)
- …absences + Maintain accurate client and caregiver documentation and schedules + Review utilization , billing, payroll, and authorization reports for accuracy + ... Clear paths for career growth and advancement + Comprehensive medical , dental, and vision insurance + 401(K) with employer...or operational needs You will report to the Branch Director . _\#ElaraGA_ _We value the unique skills of veterans… more