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$65.5k - $96.89k
R1 RCM in Detroit seeks a Utilization Review Specialist to provide admission and continued stay reviews in line with evidence-based criteria. The role demands a current RN license and 3 years of clinical nursing experience, with 2 years in Utilization Review preferred....Suggested- 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
$30.5 - $67.97 per hour
...claims and appeals in Detroit, MI. The role involves conducting reviews of medical claims, ensuring compliance with regulations and policies... .... A minimum of 2 years of nursing experience, an active RN license, and proficiency in medical coding are required. The position...SuggestedHourly pay$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
- 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 timeShift work
- 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 TitlePhysician Clinical Reviewer- Pediatric Neurology- REMOTEResponsibilitiesReviews cases in... ...Initial Clinical Reviewers as needed to discuss cases and problems.Utilizes medical/clinical review guidelines and parameters to assure...SuggestedWork at officeLocal areaRemote workVisa sponsorshipWork visaPrime Therapeutics
Lansing, MI1 day ago- OverviewMedical Review Specialist - Full time (40 hours per week), Remote in EST/CST time zones. Non-Exempt.Medlogix, LLC delivers... ...guidelines, assesses appropriate medical coding use, identifies over-utilization, and makes reimbursement recommendations. The incumbent is...SuggestedRemote jobFull timeWork at office
$30.5 - $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...SuggestedHourly payWork experience placementWork 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, MI4 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...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...Hourly payRemote workPrime Therapeutics
Lansing, MI1 day 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...
Behavioral Center of Michigan
Warren, MI4 days 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...Full 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...Full timeTemporary workWork experience placementLocal areaRemote workFlexible hoursShift workCooperman Barnabas Medical Center
Grand Rapids, MI4 days ago- ...Hospital Title Registered Nurse ( RN ) - Pediatrics Unit - Bronson Methodist... ...outcomes 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...Full timePart timeLocal areaShift workNight shift
Bronson Healthcare
Kalamazoo, MI2 days ago $31 - $43 per hour
...Medical Center is seeking a Registered Nurse (RN) Outpatient Surgery for a nursing job in... ...the scheduling process to ensure optimal utilization of the physician's time and surgical... ...data for surgical boarding process. 3. Reviews utilization of physician's O.R. block...Hourly payFull timeWork at officeLocal areaFlexible hoursShift workDetroit Medical Center
Detroit, MI13 hours 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, MI1 day 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, MI13 hours ago - ...completion of the Annual Standing Order Review and Internal Classification of Disease (ICD... ...clinic financials including efficient utilization of supplies or equipment and regular profits... ...of an accredited School of Nursing (RN). Current appropriate state licensure. Experience...
- ...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
Michigan3 days ago - ...direct and indirect patient care across the age continuum; and utilize the nursing process of assessment, planning, implementation, and... ...high level of service in all areas of responsibility. Reviews daily schedule and prepares for cases based upon preference cards...Full timeLocal area
IntelyCare
Orchard Lake, MI2 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, 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
$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, MI1 day 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, MI1 day ago
