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
- 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
$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 work- 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 leading healthcare services provider seeks a Utilization Review Coordinator in Grand Rapids, Michigan. This role involves negotiating on behalf... ...processes with insurance companies. Candidates should be RN, MA, or MSW qualified and have professional licensure in Michigan...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
- ...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
- A leading healthcare organization in Michigan is seeking a dedicated professional to review patient charts and determine the appropriate boarding status for surgical cases. The ideal candidate will have RHIT, RHIA, or related coding certification and 3-5 years of clinical...SuggestedMonday to Friday
$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$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...Remote jobWork at officeLocal area$60k
Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and...Temporary workLocal areaRemote work$45 - $50 per hour
...founded over 30 years ago by a Dialysis RN who believes everyone is entitled to excellent... ...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...Hourly payReliefWork at officeImmediate startRemote workShift work$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
$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- ...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
- ...quality care to patients in the comfort of their homes. As a Homecare RN, you will deliver primary nursing care as ordered by the... ...changes in patient condition, adjusting care plans as needed. Utilize motivational interviewing and health coaching techniques to support...Daily paidFull timeLocal areaImmediate startRelocation packageShift workDay shift
- ...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
- ...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
$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 work- ...procedures through ongoing research and review of the current literature. Ensures compliance... ...ensuring the data accurately represents utilization trends and patterns. Prepares summaries... .... Current license to practice as an RN in Michigan is required. A clinical Master...Work at officeShift work
$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 package- ...Medical Records - Field Reviewer Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides... ...requirements Qualifications: Must be an RN, LPN, Certified Coder, RHIT, RHIA, MA or Medical Records Professionals...Permanent employmentFull timeLive inWork from home

