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... 
    Suggested
    Hourly pay
    Monday to Friday

    Healthcare Support Staffing

    Troy, MI
    5 days ago
  • 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... 
    Suggested
    Part time
    Relief
    Day shift

    Corewell Health

    Caledonia, MI
    4 days ago
  • 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... 
    Suggested
    Part time
    Relief
    Shift work

    Corewell Health

    Caledonia, MI
    4 days 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

    Healthcare Support Staffing

    Troy, MI
    1 day ago
  • 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

    Healthcare Support Staffing

    Troy, MI
    1 day 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... 
    Suggested
    Full time
    Work at office
    Shift work

    Henry Ford Health - Careers

    Lansing, MI
    5 days ago
  • $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... 
    Suggested
    Remote job

    Prime Therapeutics

    Lansing, MI
    1 day ago
  • $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... 
    Suggested
    For contractors
    H1b
    Work at office
    Local area
    Remote work

    Public Consulting Group

    Lansing, MI
    3 days 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... 
    Suggested
    Casual work
    Work at office

    Infor

    Lansing, MI
    2 days ago
  • 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

    Universal Hospital Services Inc.

    Grand Rapids, MI
    4 days ago
  • 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... 
    Suggested
    Work at office

    Infor

    Lansing, MI
    1 day ago
  • 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

    Integrated Resources Inc.

    Troy, MI
    2 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

    Healthcare Support Staffing

    Troy, MI
    5 days ago
  • 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... 
    Suggested
    Monday to Friday

    Henry Ford Health System

    Troy, MI
    1 day ago
  • $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... 
    Suggested
    Remote job

    Prime Therapeutics

    Lansing, MI
    1 day ago
  • $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 job
    Work at office
    Local area

    Prime Therapeutics

    Lansing, MI
    2 days ago
  • $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 work
    Local area
    Remote work

    Integra Partners

    Lansing, MI
    5 days ago
  • $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 pay
    Relief
    Work at office
    Immediate start
    Remote work
    Shift work

    Rendevor Dialysis

    Whitmore Lake, MI
    4 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

    Prime Therapeutics

    Lansing, MI
    5 days ago
  •  ...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 time
    Part time
    Local area
    Shift work
    Day shift

    Bronson Healthcare

    Battle Creek, MI
    4 days 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 time
    Work at office
    Immediate start
    Remote work
    Flexible hours

    State of Michigan

    Lansing, MI
    3 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... 
    Relief
    Work at office
    Immediate start
    Remote work
    Shift work

    Rendevor Dialysis

    Detroit, MI
    5 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 paid
    Full time
    Temporary work
    Shift work

    AMN Healthcare

    Michigan
    3 days ago
  •  ...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 paid
    Full time
    Local area
    Immediate start
    Relocation package
    Shift work
    Day shift

    Trinity Health At Home

    Jackson, MI
    5 days ago
  •  ...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 employment
    Temporary work
    Work at office
    Flexible hours

    MyCare Health Center

    Center Line, MI
    4 days 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, MI
    4 days 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 work
    Weekend work

    Sanford Health

    Iron Mountain, MI
    4 days ago
  •  ...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 office
    Shift work

    Beacon Health System

    Kalamazoo, MI
    3 days 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 area
    Immediate start
    Relocation package

    Fox Run Village by Erickson Senior Living

    Walled Lake, MI
    2 days ago
  •  ...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 employment
    Full time
    Live in
    Work from home

    Altegra Health

    Grand Rapids, MI
    5 days ago