- 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 (Sterling Heights, MI)
- …practice in behavioral health and at least 3 years as a medical director in a managed care setting supporting utilization management and quality initiatives. ... to standardize policies and procedures. + Recruits, hires, trains, mentors, and develops medical director staff and team members as needed. + Ensures… 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
- Prime Healthcare (Port Huron, MI)
- …to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and utilization technicians. Assesses ... Connect With Us! (https://careers-primehealthcare.icims.com/jobs/239937/multi-site- director -case-management/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityLake Huron… more
- McLaren Health Care (Port Huron, MI)
- …+ Responsible for the total nursing care of residents as directed by the Medical Director , attending physician, Director of Nursing and designated ... **Position Summary:** The Registered Nurse delivers quality nursing care through the utilization of the nursing process. Works collaboratively with other members of… more
- McLaren Health Care (Port Huron, MI)
- …* Responsible for the total nursing care of residents as directed by the Medical Director , attending physician, Director of Nursing and designated ... Summary:** The License Practical Nurse delivers quality nursing care through the utilization of the nursing process. Works collaboratively with other members of the… 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
- 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