- Cognizant (Lansing, MI)
- …you need to have to be considered** + Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and… more
- CVS Health (Lansing, MI)
- …+ Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital ... is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that...setting. + A Registered Nurse that holds an active, unrestricted… more
- Trinity Health (Howell, MI)
- …Type:** Part time **Shift:** Day Shift **Description:** **POSITION PURPOSE** + The Registered Nurse Case Manager assumes overall accountability for patients' ... plans while assuming a leadership role in achieving desired clinical , financial and resource utilization outcomes. +...through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for… more
- Evolent (Lansing, MI)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals.… more
- Highmark Health (Lansing, MI)
- …years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
- Gentiva (Jackson, MI)
- …Administrator to join our leadership team. This role is ideal for a licensed Registered Nurse (RN) with strong leadership experience in hospice care, home ... health, or clinical operations management. If you're a natural leader who...growth through census development, referral management, and efficient resource utilization + Maintain strong relationships with physicians, referral sources,… more
- McLaren Health Care (Lansing, MI)
- …nursing experience providing broad clinical exposure. Current State of Michigan Registered Nurse license. + BLS certification as Healthcare Provider or ... accomplish the mission and vision of McLaren Greater Lansing through effective utilization of all resources, constantly striving to increase quality patient care and… more