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
- 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
$90.87 - $154.33 per hour
...A healthcare company in Michigan is seeking a Physician Clinical Reviewer - Cardiology to join their utilization management team. The role entails reviewing medical service requests, ensuring compliance with guidelines, and collaborating with physicians to provide critical...SuggestedRemote workPrime Therapeutics
Lansing, MI3 days ago- 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
- 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
$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$76k - $85k
...sector. To learn more, visit . PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing... ...environment, Medicaid or hospital utilization management RN required Working Conditions ~ Remote The above is...SuggestedFor contractorsH1bWork at officeLocal areaRemote workPublic Consulting Group
Lansing, MI4 days ago- 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
- 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
- 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
$18 - $20 per hour
A leading insurance services provider is seeking a Utilization Review Coordinator in Lansing, Michigan. The role involves assigning utilization review cases, verifying data, and providing support to clinical staff. Candidates should have a high school diploma, two years...SuggestedHourly pay- 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
$90.87 - $154.33 per hour
...purpose-driven career? Come build the future of pharmacy with us. Job Title : Physician Clinical Reviewer - Rheumatology - REMOTE Job Description Key member of the utilization management team, and provides timely medical review of service requests that do not initially...Work at officeLocal areaRemote workVisa sponsorshipWork visaPrime Therapeutics
Lansing, MI3 days ago$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, MI3 days ago- ...Clinical Appeals Reviewer (Licensed Healthcare Professional) Fully Remote-United States... ...including but not limited to Registered Nurses (RN), Physical Therapists (PT), Occupational... ...to Medicare managed care appeals or utilization management activities, preferred. Must...Full timeContract workPart timeFor contractorsWork at officeLocal areaRemote workNight shift
St. George Tanaq Corporation
Lansing, MI2 days ago - ...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, MI3 days ago- ...medication as ordered by physicians, tracks electronically. Utilizes the nursing process in planning, providing and evaluating each... ...and established standards of care; keeps treatment plan updated; reviews the plan with patients. Documents nursing interventions and...
Behavioral Center of Michigan
Warren, MI1 day ago - ...procedures through ongoing research and review of the current literature. Ensures compliance... ...ensuring the data accurately represents utilization trends and patterns. Prepares... ...program. Current license to practice as an RN in Michigan is required. A clinical Master...Work at officeShift work
Beacon Health System
Kalamazoo, MI3 days ago - ...professional and interpersonal communication. - Utilize a variety of pharmacologic and non-... ...Evaluation: (C) Competent (NT) Needs Training or Review. - Standards of Performance: - Seven... ...Requires a graduate of an approved professional (RN) nursing program. EP experience working...Local areaImmediate startRelocation packageShift workNight shiftWeekend work
Henry Ford Health System
Grand Blanc, MI3 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
$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, MI3 days ago- ...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, MI3 days ago - ...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
Michigan10 hours ago - ...(TPAs); and government entities we serve. Title: Medical Review Specialist Type : Full time – (40 hours per week) Non... ...Position Summary : The incumbent reviews medical bills utilizing professional knowledge and clinical experience to determine relationship...Remote jobFull timeWork at office
- ...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, MI4 days ago Physician 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, MI2 days ago
