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- ...GENERAL SUMMARY: 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...SuggestedFull timeShift work
Henry Ford Health System
Troy, MI11 hours ago - 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
$72.47k - $111.2k
...Jackson, MI area for the following position: Registered Nurse - Utilization Review. Nurses with experience in any of the following areas are... ...Retirement Plan, Tuition Assistance Qualifications: RN Diploma degree or higher from an accredited school of nursing...SuggestedDaily paidFull timePart timeShift workDay shiftIncredible Health
Parma, MI11 hours ago$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 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
- 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
...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- Overview Medical Review Specialist - Full time (40 hours per week), Remote in EST/CST time zones. Non-Exempt. Medlogix, LLC delivers... ..., assesses appropriate medical coding use, identifies over-utilization, and makes reimbursement recommendations. The incumbent is responsible...SuggestedRemote jobFull timeWork at office
- ...consultant, access a secure portal to retrieve and work clinical cases; review each set of case records for the clinical history, diagnoses,... ...to ensure accurate and defensible assessments. - Utilize understanding of Office of Personnel Management (OPM) hiring...SuggestedMinimum wageContract workTemporary workWork experience placementWork at office
MAXIMUS
Detroit, MI7 hours agonew - ...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...Suggested
$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...SuggestedHourly payRemote workPrime Therapeutics
Lansing, MI2 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...Suggested
Behavioral Center of Michigan
Detroit, MI11 hours ago $63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-61 FTE : Full-time, Exempt Unit : UAW Department/Location : Utilization... ...clinical experience post-licensure preferred); or Registered Nurse (RN) in Michigan with at least two (2) years of clinical...SuggestedFull timeTemporary workRemote workMonday to Friday$58k - $78k
...Job Title: Surgical Clinical Reviewer Location: Cooperman Barnabas Medical Ctr Department Name: Department of Surgery Req #... ...postoperative data components for the Program through the effective utilization of the hospital medical record systems. ~ Attends weekly...SuggestedFull timeTemporary workWork experience placementLocal areaRemote workFlexible hoursShift workCooperman Barnabas Medical Center
Grand Rapids, MI5 days 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, MI2 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, MI2 days ago - Dialysis Clinical Manager Registered Nurse - RN page is loaded## Dialysis Clinical... ...completion of the Annual Standing Order Review and Internal Classification of Disease (ICD... ...Manages clinic financials including efficient utilization of supplies or equipment and regular...Worldwide
- ...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 - ...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, MI2 days ago- ...A medical claims solutions provider is seeking a Medical Review Specialist to work remotely in the United States. The role involves reviewing medical bills, making reimbursement recommendations, and ensuring adherence to medical billing guidelines. Candidates should possess...Remote work
Medlogix
Southfield, MI2 days ago - ...Hospital Title Registered Nurse (RN) - Emergency Department (ED) - Bronson Lakeview... ...and timely discharge by the following: utilizing the nursing process of assessment,... ...needs/strengths for assigned patients o Reviews vital signs to assess condition of patient...Part timeReliefLocal areaShift work
Bronson Healthcare
Paw Paw, MI2 days ago $72.47k - $111.2k
...Blanc, MI area for the following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review. ~ Shift(s) available: day shift ~ Job types available:...Daily paidFull timePart timeShift workDay shiftIncredible Health
Flint, MI11 hours ago- ...Position Summary Under the direction of the Manager of Record Review and/or the Record Review Team Lead, the Record Review... ...effectively with donors, volunteers and employees of the organization utilizing instructive or persuasive skills. required Ability to work...Full timeTemporary workWork at officeMonday to FridayFlexible hours
Versiti Inc.
Grand Rapids, MI11 hours ago $110k
...rated community, is seeking an Assistant Director of Nursing, RN to help lead our CCRC a role ideal for a clinical leader... ...dehydration. Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S)...Local areaImmediate startRelocation packageFox Run Village by Erickson Senior Living
Novi, MI4 days ago$41.78 - $64.81 per hour
...to society. Responsibilities* Utilize the nursing process to facilitate patient... ...Three years of nursing experience as an RN within the last 5 years. Care of immunocompromised... ...hiring department. Work agreements are reviewed annually at a minimum and are subject to...Hourly payFull timeTemporary workPart timeWork at officeImmediate startRemote workMonday to FridayShift workNight shiftWeekend workDay shiftAfternoon shiftUniversity of Michigan
Ann Arbor, MI11 hours ago- ...telemedicine provider in Michigan is seeking a Registered Nurse to handle patient communications, review lab results, and resolve inquiries. The ideal candidate should possess an active RN license and strong communication skills. Key responsibilities include documenting client...
$41.78 - $64.81 per hour
...Ambulatory Care, Pre-Transplant Adult Kidney RN Coordinator Apply Now Mission... ...Ability to manage complex clinical issues utilizing assessment skills, protocols, and evidence... ...the hiring department. Work agreements are reviewed annually at a minimum and are subject to...Hourly payFull timeTemporary workPart timeImmediate startRemote workMonday to FridayShift workNight shiftWeekend workDay shiftAfternoon shiftUniversity of Michigan
Ann Arbor, MI2 days ago
