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- 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
- 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 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
- ...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
Warren, MI4 days 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
$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 job$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, MI11 hours ago- 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
- 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
$75k - $100k
Our Utilization Management RN (Registered Nurse) evaluates efficiency, appropriateness, and medical necessity for medical services and procedures... ...This role uses clinical knowledge to provide judgment in reviewing medical services with evidence‑based criteria, authorizing...SuggestedFor contractorsWork at officeLocal areaImmediate startRemote work- ...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
...serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Physician Clinical Reviewer - Ophthalmology (REMOTE) Key member of the utilization management team, and provides timely medical review of service requests that do not initially meet the...SuggestedRemote jobWork at officeLocal area$90.87 - $154.33 per hour
...pharmacy benefit manager is seeking a remote Physician Clinical Reviewer - Allergy/Immunology to conduct medical reviews and interact... ...possess a DO, MBBS, or MD, with 5+ years of clinical experience in utilization management. This role requires effective communication skills...SuggestedRemote job$1,924 per week
...Staffing-Nursing is seeking a travel nurse RN PreOp / PACU - Post Anesthesia Care for a... ...patients pre-operatively, including reviewing medical history, performing physical examinations... ...Respond promptly to emergency situations utilizing Pre/post op nursing standards, policies,...Weekly payTemporary workShift workNight shiftFusion Medical Staffing-Nursing
Saint Joseph, MI2 days ago$90.87 - $154.33 per hour
A healthcare organization seeks a Physician Clinical Reviewer in Ophthalmology (REMOTE) to join a utilization management team. The role requires reviewing clinical cases, ensuring compliance with medical necessity guidelines, and interacting with physicians and other stakeholders...Remote job- ...Bronson Battle Creek Registered Nurse (RN) Oncology Unit FT 12D Under general supervision... ...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...Full timePart timeLocal areaShift workDay shift
Bronson Healthcare
Battle Creek, MI1 day ago $200k
...representing DHHS in beneficiary hearings, conducting Department Reviews and performing other duties assigned by the position’s... ...download and 5 Mbps upload. Suitable lighting, furniture, and utilities. Condition of Employment This position requires successful completion...Full timeWork at officeImmediate startRemote workFlexible hours- ...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 employment
Advantage Health Centers
Detroit, 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 $31 - $42 per hour
...Medical Center is seeking a Registered Nurse (RN) Case Management for a nursing job in... ...Summary Description Oversees hospital utilization performance improvement and operational management... ..., c) ensures medical necessity review processes are completed accurately and in...Hourly payFull timeLocal areaFlexible hoursShift workDetroit Medical Center
Hamtramck, MI1 day 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
- ...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
Michigan11 hours ago $34 - $51.76 per hour
...Summary Registered Nurse The Registered Nurse (RN) is responsible for utilizing the nursing process (assessment, diagnosis, outcomes/... ...order to carry out the essential functions of the position. Reviews and meets ongoing competency requirements of the role to...Shift workWeekend workSanford Health
Iron Mountain, MI2 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...Remote jobHourly pay- ...company assistance in understanding and utilizing your benefit options. Pet Insurance :... ...MediLodge today! Summary: The Wound Care RN plans, coordinates, and provides total... ...employment laws. For further information, please review the Know Your Rights notice from the...Bi-weekly payHourly payWeekly payDaily paidTemporary workFlexible hours
Medilodge
Lansing, MI7 hours agonew - ...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, MI1 day ago - ...This position is a remote role for nurses in Michigan. Candidates should have a valid MI RN license and utilization management experience. Experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously is required. The candidate...Remote work
LanceSoft
Detroit, MI1 day ago $110k
...dehydration. Participating in Wound Rounds, Operations Meetings, Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S)... ...Salary based on experience* What you will need Current RN nursing license with no restrictions for the state in which...Local areaImmediate startRelocation packageFox Run Village by Erickson Senior Living
Farmington Hills, MI5 days ago
