- McLaren Health Care (Flint, MI)
- …to help people live healthier and more satisfying lives. We are looking for a Utilization Management RN, to join in leading the organization forward. MHP is a ... service to all our members. **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited to… more
- Cognizant (Lansing, MI)
- …- Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' experience in ... 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)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... **Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- CVS Health (Lansing, MI)
- … solutions that promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant, where you'll ... a computer. + Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM...are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence… more
- Trinity Health (Howell, MI)
- …Type:** Part time **Shift:** Day Shift **Description:** **POSITION PURPOSE** + The Registered Nurse Case Manager assumes overall accountability for patients' ... leadership role in achieving desired clinical, financial and resource utilization outcomes. + This is achieved by coordinating care...through Friday. **WHAT YOU WILL DO** + The RN Registered Nurse Case manager is responsible for… more
- Fresenius Medical Center (Lansing, MI)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… 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, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
- McLaren Health Care (Lansing, MI)
- …professional nursing experience providing broad clinical exposure. Current State of Michigan Registered Nurse license. + BLS certification as Healthcare Provider ... Assists Manager of Patient Care Services with 24-hour accountability for the management of multiple patient care units/functions. In this capacity, will accomplish… more
- Highmark Health (Lansing, MI)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- CVS Health (Lansing, MI)
- …conditions. + **Diabetes education experience** is required. + Current, unrestricted ** Registered Nurse (RN) license** ; multi-state licensure preferred. + ... health outcomes by engaging telephonically with individuals living with diabetes. This nurse will guide members through actionable steps to close gaps in care,… more
- Gentiva (Flint, MI)
- …Director to join our leadership team. This role is ideal for a licensed Registered Nurse (RN) with strong leadership experience in hospice care, home health, ... budgeting while driving branch revenue growth through census development, referral management , and efficient resource utilization + Maintain strong relationships… more
- McLaren Health Care (Flint, MI)
- …department policies, procedures, protocols and regulations. #LI-KH1 _Required:_ + Licensed as a Registered Nurse to practice nursing in Michigan + BSN or ... **Position Summary:** Has responsibility for 24-hour accountability for the management of assigned patient care unit(s)/function(s). In this capacity, will… more