- Humana (Lansing, MI)
- **Become a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to ... independent determination of the appropriate courses of action. The Utilization Management Registered Nurse...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- Trinity Health (Howell, MI)
- …weeks from 8 am to 5 pm Monday through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for conducting a focused assessment ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...and clinical risk issues and documentation completeness. + The RN Registered Nurse Case Manager… more
- Highmark Health (Lansing, MI)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- McLaren Health Care (Lansing, MI)
- …* Bachelor's degree in coding/medical records/billing or UM * Two years of case management or utilization review experience * Three years of recent ... between patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure that… more
- Highmark Health (Lansing, MI)
- …Remote - Part Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- CVS Health (Lansing, MI)
- …Configures the case management system to organize cases dealing with disease management and utilization review ; tracks patient progress and manages ... + Case Management experience in the insurance industry + Compact RN licensure + Certified Case Manager + Telephonic Nursing experience + Home Health… more
- CVS Health (Lansing, MI)
- …affordable. **Position Summary:** The Associate Manager is responsible for oversight of Utilization Management /Case Management staff. This position is ... department + 3+ years inpatient clinical experience as a Registered Nurse + 3+ years of Managed...years of Managed Care experience + 1+ years of Utilization Management experience + 1+ year Leadership… more
- Guardian Life (Lansing, MI)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more