- Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members.
- May establish care plans and coordinate care through the health care continuum including member outreach assessments.
- Above average computer skills (Microsoft office).
- Clinical experience in ICU, ER, or medical surgical unit preferred.
- Prefer utilization management experience.
- Resource will be able to perform this role offsite. May be required to come into the office for meetings and training.
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rn-registered nurse utilization review
Found in: Careerbuilder One Red US C2 - 3 days ago
Ascension Health , MI, United States**Details** · + **Department: Case Management** · + **Schedule: Full Time Days M-F 8AM - 4PM No Weekends or Holidays** · + **Hospital: Ascension Providence** · + **Location: Currently remote but could change Southfield, MI** · **Benefits** · Paid time off (PTO) · Various health i ...
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rn-registered nurse utilization review
Found in: Careerbuilder One Red US C2 - 4 days ago
Ascension Health , MI, United StatesDetails · * Department: Case Management · * Schedule: Full Time Days M-F 8AM - 4PM No Weekends or Holidays · * Hospital: Ascension Providence · * Location: Currently remote but could change Southfield, MI · Benefits · Paid time off (PTO) · Various health insurance options & welln ...
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clinical nurse reviewer- st. mary mercy livonia
Found in: Careerbuilder One Red US C2 - 3 days ago
Trinity Health , MI, United States**Employment Type:** · Full time · **Shift:** · Rotating Shift · **Description:** · HMS collaborative reviewer · The Clinical Nurse Reviewer's chief responsibility is to collect and submit reliable data on eligible cases as required for participation in the Michigan Hospital Medi ...
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Nurse Practitioner or Physician Assistant
Found in: SonicJobs Direct Apply US - 2 days ago
MRG Exams Warren, United States Full timeWork can be performed by a Nurse Practitioner or Physician Assistant · We are looking for the right Nurse Practitioner or Physician Assistant to perform medical assessments on United States Veterans as part of the VA's disability benefits process. · In performing Disability Asses ...
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rn registered nurse
Found in: J-Vers US C2 - 4 days ago
Ascension Health , MI, United StatesDetails · * Sign-on bonus: $3,000.00 · * Department: Emergency Department · * Schedule: Part Time Days 7 am - 7:30 pm Monday- Friday and every other weekend · * Hospital: Ascension Genesys · * Location: Grand Blanc, Michigan · Benefits · Paid time off (PTO) · Various health insur ...
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registered nurse
Found in: J-Vers US C2 - 4 days ago
Ascension Health , MI, United StatesDetails · * Sign-on bonus: $8,000.00 · * Department: Emergency Department · * Schedule: Part Time Nights 7 pm - 7:30 am Monday - Friday and every other weekend · * Hospital: Ascension Genesys · * Location: Grand Blanc, Michigan · Benefits · Paid time off (PTO) · Various health in ...
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rn registered nurse
Found in: J-Vers US C2 - 4 days ago
Ascension Health , MI, United StatesDetails · * Sign-on bonus: $3,000.00 · * Department: Emergency Department · * Schedule: Part Time Evenings 11 am -11:30 pm Monday-Friday and every other weekend · * Hospital: Ascension Genesys · * Location: Grand Blanc, Michigan · Benefits · Paid time off (PTO) · Various health i ...
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rn registered nurse
Found in: J-Vers US C2 - 4 days ago
Ascension Health , MI, United StatesDetails · * Department: Surgical, Oncology, General Medicine, Hospice · * Schedule: Full Time Nights 7P-7:30A and every other weekend Saturday/Sunday · * Hospital: Ascension Genesys · * Location: Grand Blanc, Michigan · Benefits · Paid time off (PTO) · Various health insurance op ...
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rn registered nurse
Found in: J-Vers US C2 - 4 days ago
Ascension Health , MI, United StatesDetails · * Sign-on bonus: $20,000.00 · * Department: Orthopedics & Neurology · * Schedule: Full Time Nights 7 pm - 7:30 am Monday - Friday and every other weekend · * Hospital: Ascension Genesys · * Location: Grand Blanc, Michigan · Benefits · Paid time off (PTO) · Various healt ...
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registered nurse ob prn
Found in: Adzuna US C2 - 4 days ago
LifePoint Hospitals , MI, United StatesProvides direct patient care to laboring women and newborns using the nursing process in accordance with applicable scope and standards of practice. · Performs plan of care intervention, including medication administration, specimen collection, clinical treatments, as well as oth ...
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director of nursing nurse skilled nursing facility
Found in: MyJobHelper US C2 - 3 days ago
Avista Nursing and Rehab , MI, United StatesAvista Nursing and Rehab - The Director of Nursing Services is an RN, who assumes responsibility and accountability for nursing and clinical services. Although interdisciplinary effort is required, nursing and clinical services include but not limited to; patient quality of life, ...
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director of nursing
Found in: MyJobHelper US C2 - 3 days ago
NPAworldwide , MI, United StatesDIRECTOR OF NURSING -Location: Kalamazoo, Michigan. · Direct Hire · Competitive Compensation based on experience. · Full-time · Benefits Package · Relocation Assistance Available - Possible. · Bonus Eligible - Yes · We are currently searching for a Director of Nursing for a 97-be ...
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director of nursing
Found in: MyJobHelper US C2 - 3 days ago
McCulloh Consulting , MI, United StatesAbout the job Director of Nursing · Are you a Director of Nursing with a background in long term care and skilled nursing facilities? Do you possess a Michigan RN license and the desire to manage a facility's nursing program? Do you want to live in the Kalamazoo area and find ou ...
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registered nurse
Found in: Careerbuilder One Red US C2 - 3 days ago
w3r Consulting , MI, United StatesResponsible for the review of precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual criteria. Required to enter or reference data via PC, collaborate with facilities, providers and Medical Directors. Must have excel ...
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director case management ft days
Found in: MyJobHelper US C2 - 2 days ago
TNG , MI, United StatesDetails: · Department OperationsMaintains an adequate number and skill mix over seven days a week to serve the patient population and meet the goals of the department. · Implements and supports with business case staffing requests utilizing the Tenet Case Management staffing rec ...
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immunization clinic supervisor
Found in: MyJobHelper US C2 - 3 days ago
Ingham County, MI , MI, United StatesSalary : $73, $88,016.64 Annually · Location : Lansing, MI · Job Type: Regular Full Time · Job Number: · Department: Immunization Clinic · Opening Date: 04/05/2024 · Closing Date: Continuous · Bargaining Unit: MNA NP/CN · Description · **Applications are accepted until there are ...
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rn med surg
Found in: MyJobHelper US C2 - 3 days ago
Infojini , MI, United States: · Essential Functions and Responsibilities: · Assesses the physical, psychosocial, and educational needs of the patient. · Plans and implements nursing care according to patient and family needs. · Makes appropriate interventions based upon individual patient needs. · Evaluates ...
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patient care technician
Found in: MyJobHelper US C2 - 3 days ago
DaVita Inc. , MI, United States2766 Washtenaw Ave, Ypsilanti, Michigan, 48197, United States of America · DaVita is hiring a Dialysis Tech to give life in the greater ____________ area. · You can make an exceptional difference in the lives of our patients and their families dealing with end-stage renal failure ...
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scheduler
Found in: MyJobHelper US C2 - 2 days ago
Omni Continuing Care , MI, United StatesOmni Continuing Care - Are you an STNA looking for a new challenge? Our Scheduler is an STNA who provides staffing and scheduling for the nursing staff to ensure that the highest degree of quality care can be provided to our residents at all times. · You will work closely with th ...
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nurse educator
Found in: Careerbuilder One Red US C2 - 2 hours ago
Sparrow Health System , MI, United States: · Positions Location: Lansing, MI · Job Description · Purpose of Job: · Coordinate regional transport services for the RNICU and facilitate nursing orientation and education in RNICU. Develops, plan and implements educational activities to foster the advancements of competencie ...
registered nurse-review analys - , MI, United States - LanceSoft Inc
Description
Job Description:Requested criteria: