- Tenet Healthcare (Detroit, MI)
- RN Utilization Review - Case ...dedicated healthcare team where compassion meets innovation! As a Registered Nurse with us, you'll have the ... level of care Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as...required. One (1) year hospital acute or behavioral health case management experience preferred. Active and valid RN… more
- Henry Ford Health System (Detroit, MI)
- …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... with computers, electronic health records (EHR), database systems, and utilization review / case management documentation systems....work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
- Tenet Healthcare (Detroit, MI)
- Registered Nurse ( RN ) - Case Manager - 2506003285 Description : Join our dedicated healthcare team where compassion meets innovation! As a Registered ... and is determined by employment status Job Description: The RN Case Manager is responsible to facilitate...management experience preferred. 3. License to practice as a Registered Nurse in the State of Michigan.… more
- Trinity Health (Ann Arbor, MI)
- …6-8 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 ... 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… more
- McLaren Health Care (Port Huron, MI)
- …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... **Department:** Utilization Review **Daily Work Times:** 8:00am-4:30pm...peer reviews with payer/providers. 7. Actively participates in clinical case review /rounds with the interdisciplinary team regarding… more
- University of Michigan (Ann Arbor, MI)
- REGISTERED NURSE - Partial Hospitalization Program **Early Site Maintenance** We are performing updates and maintenance to our applicant experience. As a result, ... not be submitted. Apply Now **Job Summary** The Psychiatric Registered Nurse is responsible for initial assessments,...QI data that is pertinent to the role, including Utilization Review data. **Mission Statement** Michigan Medicine… more
- Veterans Affairs, Veterans Health Administration (Ann Arbor, MI)
- Summary The LTC Charles S. Kettles VA Medical Center is seeking a Full-Time Registered Nurse ( RN ) - Inpatient Community Living Center (CLC), aligned under ... Patient Care Services. Responsibilities Inpatient Staff Registered Nurse ( RN ) is responsible for providing competent, evidence-based care to assigned… more
- Tenet Healthcare (Commerce Township, MI)
- …planning experience. Preferred: Acute hospital case management experience. Required: RN . Must be currently licensed, certified, or registered to practice ... RN Case Manager - Clinical Res...staff and ancillary departments, k) leading and facilitating Complex Case Review , l) assuring patient education is… more
- CVS Health (Lansing, MI)
- …of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ... phone, computer, etc. and clinical documentation systems. + 1+ Year of Utilization Review Management and/or Medical Management experience. + Commitment to… more
- Trinity Health (Muskegon, MI)
- …of care across the care continuum for patients. Facilitates appropriate resource utilization and review as medically necessary. Ensures efficient patient ... obtained within 4 years of hire; or ADN only, if nationally certified in Case Management. **Credentials/Licensure** Minimum: Current RN license in the State of… more
- Trinity Health (Livonia, MI)
- …and applied criteria. Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and ... Opportunity to Join our Remarkable Care Team as a** ** Case Manager** **in the Case Management Department...accrediting agency standards and regulations relative to utilization review . **BENEFITS AVAILABLE TO YOU AS… more
- Molina Healthcare (Grand Rapids, MI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... **Job Description** **Job Summary** The Medical Review Nurse provides support for medical...our Appeals and Grievances department. We are seeking a Registered Nurse with previous Appeals experience. The… more
- Tenet Healthcare (Detroit, MI)
- …provisions and provides interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for and drafts or defines ... to ensure timely referral, follow up and documentation. Implements and monitors utilization review process in place to communicate appropriate clinical data to… more
- University of Michigan (Ann Arbor, MI)
- …degree RN + At least 2-5 years of experience in Utilization Management, Appeals Management or Case Management + Current/active certification/licensing ... be self-directed and work independently **Desired Qualifications + Experience with a case management/ utilization management software program and EPIC (MiChart) +… more
- Corewell Health (Royal Oak, MI)
- …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
- CenterWell (Portage, MI)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Prime Healthcare (Port Huron, MI)
- …leadership and supervision to case managers, social workers and case management coordinators/discharge planners, utilization review coordinators and ... computer skills. Preferred qualifications: 1. Healthcare professional licensure required as Registered Nurse , Licensed Clinical Social Worker (LCSW), or Licensed… more
- Corewell Health (St. Joseph, MI)
- …Nursing + 5 years of relevant experience previous nursing or CDE clinical experience + MI Registered Nurse ( RN ) + AHA or ARC Basic Life Support (BLS) within ... education, follow-up and emotional support to the population and their families. Case manages the population throughout the inpatient and outpatient settings and… more
- Highmark Health (Lansing, MI)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of health ... State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC). + Delaware RN license must be obtained within… more
- US Tech Solutions (MI)
- …compliance with regulatory and accreditation guidelines and company policies and procedures **Skills:** + Utilization review + RN + Assure care + Clinical ... **Timing: M-F 8-5** **Job Description:** The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and… more