- Munson Healthcare (Traverse City, MI)
- …interdisciplinary team members, payers and external case managers Why work as a Utilization Review Specialist at Munson Healthcare? + Our dynamic work ... 5 years of start date. + Current licensure as Registered Nurse in the State of Michigan....+ Minimum of three years clinical experience required. Previous utilization review and/or case management in a… more
- LifePoint Health (Hancock, MI)
- …growth of our employees both professionally and personally. We are seeking a detail-oriented Utilization Review Registered Nurse to be responsible for ... outpatient testing along with determining medical necessity of patient while hospitalized. Our Utilization Review RN will be part of an excellent team of… more
- Ascension Health (Kalamazoo, MI)
- …Manager Certification (CCMC) obtained prior to hire date or job transfer date. + Registered Nurse credentialed from the Michigan Board of Nursing obtained prior ... Preferences** There will be a dual focus on case management and utilization review in this position + Case Management experience - Strongly preferred +… more
- 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 2...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- McLaren Health Care (Detroit, MI)
- …records/billing or healthcare related field + Two years of case management or utilization review , billing, or coding experience + Three years of recent ... **Position Summary:** Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay… more
- Molina Healthcare (Warren, MI)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... care/medical experience. R **equired License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. Must have… more
- G-TECH Services, Inc. (Detroit, MI)
- …- Include: * Must be a RN with a current and unrestricted Registered Nurse license **Category** _Benefits_ **Function** _HR / Benefits_ **Req ID** _JN ... which may include acute patient care, discharge planning, case management, and utilization review , etc. Demonstrated clinical knowledge and experience relative… more
- G-TECH Services, Inc. (Detroit, MI)
- …experience in an acute care setting Education/Certifications - Include: * Must be a RN with an unrestricted Registered Nurse license **Category** _Benefits_ ... which may include acute patient care, discharge planning, case management, and utilization review with another insurance provider, etc. Demonstrates clinical… 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
- Corewell Health (Farmington Hills, MI)
- …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required How ... patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). +… 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
- Munson Healthcare (Manistee, MI)
- …experience will be considered in lieu of a Bachelor's degree in nursing (must have RN license). If Registered Nurse , must be licensed to practice in ... facilitate the progress of completing complex post-acute services 19. Interface with utilization review specialists to stay current on patient's eligibility for… 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] ... and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a valid, unrestricted State of Michigan… more
- Trinity Health (Muskegon, MI)
- …behavioral health care to ensure reimbursement for care and will work with utilization review , insurance companies, and community mental health agencies to ... or university in nursing, Bachelor of Science in Nursing (BSN) preferred + Current RN Licensure in the State of Michigan, BLS + 1-2 years' experience working with… more
- CenterWell (Flint, MI)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Corewell Health (Dearborn, MI)
- …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - STATE_MI State of Michigan Upon Hire ... for groups of patients as it relates to disease management, resource utilization , access, discharge planning, quality, service and efficiently across the continuum.… more
- ChenMed (Eastpointe, MI)
- …with bachelor's degree in home in a related clinical field preferred. + A valid, active Registered Nurse ( RN ) license in State of employment required. + A ... great people to join our team. The Community Care Nurse is responsible for enhancing the quality of patient...effectiveness through the integrating and functions of case management, utilization review and discharge planning. The incumbent… more
- Trinity Health (Ann Arbor, 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
- 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
- McLaren Health Care (Petoskey, MI)
- …QUALIFICATIONS REQUIRED + Bachelor's degree in a health-related field + State license as a Registered Nurse ( RN ) + Four years of professional experience in ... equipment purchases. + Fosters smoothly running case management and utilization review services and processes through timely...RN patient care and case management and/or utilization review QUALIFICATIONS PREFERRED + Master's degree… more