Average salary: $65,402 /yearly
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$33 - $37 per hour
A national healthcare staffing firm seeks an experienced RN Utilization Review Nurse in Troy, MI. Responsibilities include utilization review for Medicaid and Medicare, managing authorization processes, and collaborating with healthcare teams to ensure quality care. Ideal...SuggestedHourly payMonday to Friday- RN Utilization Review Specialist PRN Corewell Health Location: 4700 60th St - Grand Rapids, MI Employment Type: Part time Shift: Day (United States of America) Hours of Work: 8:00 a.m. to 4:30 p.m. Job Responsibilities Provides health information, interacts and acts...SuggestedPart timeReliefShift work
- A regional healthcare provider is seeking a part-time RN Utilization Review Specialist in Caledonia, Michigan. The role involves assessing inpatient admissions, advocating for patients within acute care services, and educating medical staff on utilization management. Ideal...SuggestedPart timeReliefDay shift
$29.05 - $67.97 per hour
A healthcare provider in Michigan seeks a Clinical Reviewer to support medical claim and internal appeals activities. The role includes clinical... ...include a minimum of 2 years in clinical nursing and a valid RN license. Preferred qualifications include additional healthcare...SuggestedHourly pay- A national healthcare staffing firm is seeking an experienced Registered Nurse for a position focused on Utilization Review. This role involves collaborating to enhance care continuity and conducting reviews for Medicaid and Medicare patients. The ideal candidate will...Suggested
- A healthcare staffing firm is seeking an experienced Registered Nurse in Michigan to provide utilization review for healthcare services. Candidates should possess a valid RN license and experience in both utilization review and Interqual. This opportunity offers a competitive...Suggested
- Overview Under minimal supervision, reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Combines clinical, business, regulatory knowledge, and skill to reduce significant financial risk and...SuggestedFull timeWork at officeShift work
$33 - $37 per hour
...today to see how a conversation can turn into a long‑lasting and rewarding career! Job Description Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the...SuggestedPrivate practiceWork at office- A leading healthcare provider in Michigan is looking for a Utilization Review professional to ensure accurate data entry and provide administrative support in patient scheduling. The role involves engaging with clients to facilitate their treatment process and communicating...Suggested
- Job Summary Reviews and screens the appropriateness of services, the utilization of hospital resources and the quality of patient care rendered. Essential Functions Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and...SuggestedCasual workWork at office
- Position Overview This Utilization Review role is primarily responsible for accurate data entry and administrative support, including patient scheduling and registration via phone and computer systems. The position also plays an important front‑line role in client engagement...Suggested
- A healthcare company is seeking a Registered Nurse for Utilization Management in Michigan. This role involves reviewing services and patient care quality, conducting stay reviews, and preparing appeals to payors. Candidates must be licensed in Michigan with three years...SuggestedWork at office
- A leading staffing firm is seeking a Utilization Management professional who is responsible for inpatient medical necessity and utilization review. The ideal candidate will have an RN license, strong problem-solving skills, and at least 4 years of clinical nursing experience...Suggested
- ...Medical Review Specialist Medlogix, LLC delivers innovative medical claims solutions through a seamless collaboration of our Medlogix... .... Position Summary: The incumbent reviews medical bills utilizing professional knowledge and clinical experience to determine relationship...SuggestedRemote jobWork at office
$90.87 - $154.33 per hour
...build the future of pharmacy with us. Job Title Physician Clinical Reviewer- Pediatric Neurology- REMOTE Responsibilities Reviews cases in... ...Clinical Reviewers as needed to discuss cases and problems. Utilizes medical/clinical review guidelines and parameters to assure consistency...SuggestedWork at officeLocal areaRemote workVisa sponsorshipWork visaPrime Therapeutics
Lansing, MI2 days ago$26.01 - $68.55 per hour
...coordinate clinical solutions. The role requires a nursing degree and 2-3 years of professional experience. Responsibilities include reviewing claims, training staff, and providing support to customer service teams. The company offers a competitive pay range of $26.01 - $6...Hispanic Alliance for Career Enhancement
Lansing, MI12 hours ago$29.05 - $67.97 per hour
...support for medical claim and internal appeals review activities - ensuring alignment with... ...Resolves escalated complaints regarding utilization management and long-term services and supports... ...and experience. Registered Nurse (RN). License must be active and unrestricted...Hourly payWork experience placementWork at office$26.01 - $68.55 per hour
...clinical judgment and perform duties as a nurse. Review and interpret clinical documentation... .... Apply clinical decision‑making to utilize appropriate clinical criteria and policies... ...requirements. Qualifications Nursing degree (RN). Minimum of 2‑3 years of professional experience...Full timeLocal areaFlexible hoursHispanic Alliance for Career Enhancement
Lansing, MI12 hours ago$60k - $65k
A healthcare services company is seeking a Remote RN to utilize evidence-based tools for evaluating prescribed medications and ensuring... ...assessments, collaborating with healthcare professionals, and reviewing drug usage guidelines. An active RN license and two years of...Remote job- ...you! Responsibilities Provides concurrent review and prior authorizations (as needed)... ...policy for Molina members as part of the Utilization Management team Identifies appropriate benefits... ...Provider environment (at least one year) RN License in Michigan Interqual experience...
$90.87 - $154.33 per hour
...healthcare solutions company is seeking a Physician Clinical Reviewer for a remote role focused on timely medical reviews of service... ...to ensure compliance with medical necessity guidelines and the utilization management process, making this a critical position in the care...Hourly payRemote workPrime Therapeutics
Lansing, MI2 days ago- ...founded over 30 years ago by a Dialysis RN who believes everyone is entitled to excellent... ...as a resource for staff. You will be utilizing your assessment skills, technical skills,... ...based on current knowledge; consistently reviews and evaluates priorities as changes occur...ReliefWork at officeImmediate startRemote workShift work
- ...A healthcare company is looking for a Medical Bill Coordinator to review and process medical bills remotely. The ideal candidate must have a high school diploma and at least two years of experience in workers compensation or bill reviews, with knowledge of medical terminology...Remote work
Sedgwick
Lansing, MI2 days ago - ...Administers medication as ordered by physicians, tracks electronically. Utilizes the nursing process in planning, providing and evaluating each... ...established standards of care; keeps treatment plan updated; reviews the plan with patients. Documents nursing interventions and...
- ...Job Details MS RN's care for adult patients who are acutely ill with a wide variety... ...quality nursing care through the utilization of the nursing process. Works collaboratively... ...forward Upon Submission: AHSA will review and deem a clinician's application eligible...Daily paidFull timeTemporary workShift work
AMN Healthcare
Michigan4 days ago - ...Title Operating Room Registered Nurse (RN) Internship - Bronson Methodist... ...needs/strengths for assigned patients o Reviews vital signs to assess condition of patient... ...plan individualized to the patient o Utilizes the patient/family input when defining outcomes...Full timeInternshipLocal areaShift workNight shiftDay shift
Bronson Healthcare
Kalamazoo, MI3 days ago $90.87 - $154.33 per hour
...A care-focused pharmacy organization seeks a Physician Clinical Reviewer specializing in dermatology. This remote position involves reviewing service requests, collaborating with healthcare providers, and ensuring compliance with medical necessity guidelines. Candidates...Hourly payRemote workPrime Therapeutics
Lansing, MI2 days agoPhysician Assistant / ObGyn / Michigan / Permanent / Peer Reviewer - Clinical - Physician, Physician
...JOB TITLE: Clinical Peer Reviewer REPORTS TO: President & CEO DEPARTMENT: Peer Review Committee FLSA STATUS: Hourly ? Non Exempt Summary Description Reviews patient information to ensure treatment/service provided falls within the plan guidelines and that...Hourly payPermanent employmentAdvantage Health Centers
Detroit, MI1 day ago- ...as independent contractors. This telework opportunity allows for schedule flexibility and involves conducting comprehensive medical reviews and providing objective opinions without establishing a doctor-patient relationship. Applicants must have a Michigan license and at...For contractorsRemote work
Dane Street
Lansing, MI2 days ago - ...families. ~ Collect and construct identifying information by reviewing past and present medical, social, and family histories,... ...according to patient wishes. ~ Charts in the medical record utilizing age-appropriate wellness assessment tools, assuring accurate...Permanent employmentTemporary workWork at officeFlexible hours
MyCare Health Center
Center Line, MI5 days ago
