• Case Manager / PRN ( RN / RT / SW / LPN )

    Select Medical (Ypsilanti, MI)
    … within the plan of care. + Demonstrates compliance with facility-wide Utilization Management policies and procedures. + Coordinates UR compliance with ... what is right. The Case Manager is responsible for utilization reviews and resource management , discharge planning,...**Current licensure in a clinical discipline either as a Nurse (RN / LPN / LVN)or a Respiratory Therapist… more
    Select Medical (03/14/25)
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  • Trainer - Clinical Services - Utilization

    Molina Healthcare (Detroit, MI)
    …Responsible for the development, implementation, and delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. Leads ... SKILLS & ABILITIES** : + 2 or more years in case, disease or utilization management ; managed care; or medical/behavioral health settings. + One year of… more
    Molina Healthcare (03/13/25)
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  • Revenue Integrity - Nurse Auditor

    Trinity Health (Ann Arbor, MI)
    …**MINIMUM QUALIFICATIONS** **Licensure/Certification:** Registered Nurse or Licensed Vocational Nurse / Licensed Practical Nurse and graduate of ... financing and managed care. Knowledge of and experience in case management and utilization management . Outpatient CDI experience preferred. Knowledge of… more
    Trinity Health (03/13/25)
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  • Registered Nurse Case Manager Contingent…

    Tenet Healthcare (Detroit, MI)
    …national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition ... Registered Nurse Case Manager Contingent Days - 2506000442 Description...q) and other duties as assigned. POSITION SPECIFIC RESPONSIBILITIES: Utilization Management : Balances clinical and financial requirements… more
    Tenet Healthcare (03/04/25)
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  • Manager, Healthcare Services (Remote)

    Molina Healthcare (Detroit, MI)
    Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse ( LPN ) with experience in lieu of RN license. ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.),… more
    Molina Healthcare (03/07/25)
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  • Manager, HCS Clinical Policy - Medicare (Remote)

    Molina Healthcare (Detroit, MI)
    Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse ( LPN ) with experience in lieu of RN license ... integrated) performing one or more of the following activities: utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.).… more
    Molina Healthcare (02/14/25)
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  • Program Manager, HCS RN, LMSW, LMHC, LMFT, or LPC…

    Molina Healthcare (Detroit, MI)
    Nurse or equivalent combination of Licensed Vocational Nurse (LVN) or Licensed Practical Nurse ( LPN ) with experience in lieu of RN license. ... years in one or more of the following areas: utilization management , case management , care...third party regulations. **Required License, Certification, Association** + If licensed , license must be active, unrestricted and in good… more
    Molina Healthcare (03/21/25)
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  • Manager of Case Management RN or LMSW

    Tenet Healthcare (Detroit, MI)
    Manager of Case Management RN or LMSW - 2406002577 Description : DMC Sinai-Grace Hospital is DMC’s largest hospital, offering a comprehensive heart center, cancer ... to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to… more
    Tenet Healthcare (02/12/25)
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  • Unit Clerk

    Behavioral Center of Michigan (Detroit, MI)
    …and compiles records for the unit. Upholds system and organization in the nurse station, giving assistance to the assigned clinical staff in the unit. Performs ... for discharge/transfer. Makes appropriate copies for various departments (Nursing, Utilization Review, Billing, and Partial Hospitalization Program). + Collects… more
    Behavioral Center of Michigan (03/09/25)
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