Expired Utilization Management Nurse jobs in Detroit, MI
Detroit, MI
$18,786-$159,703/year (est.)
The Nurse will have thorough knowledge of patient medical records and is able to retrieve pertinent information from multiple sources/packages for case review (e. g., CPRS, VistA, etc.). As a UM nurse, will possess functional knowledge of VERA reimbursement model, Managerial Cost Accounting (MCA),...
Detroit, MI
$18,818-$159,703/year (est.)
Responsibilities: Develop 60 day orientation/training schedule for new clinical utilization management staff Monitor staff progress weekly and update training orientation outline accordingly Provide at least weekly written progress reports to manager and updated training outline Discuss issues or...
Detroit, MI
$18,818-$159,703/year (est.)
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care...
Detroit, MI
$18,818-$159,703/year (est.)
This is a telework role with a potential for office based training in Detroit, MI. Applicants external to Aetna must be a commutable distance to Detroit. POSITION SUMMARY Utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit...
Detroit, MI
$18,786-$159,703/year (est.)
Summary Duties The Nurse will have thorough knowledge of patient medical records and is able to retrieve pertinent information from multiple sources/packages for case review (e. g., CPRS, VistA, etc.). As a UM nurse, will possess functional knowledge of VERA reimbursement model, Managerial Cost...
Detroit, MI
$18,818-$159,703/year (est.)
Responsibilities: Develop 60 day orientation/training schedule for new clinical utilization management staff Monitor staff progress weekly and update training orientation outline accordingly Provide at least weekly written progress reports to manager and updated training outline Discuss issues or...
Detroit, MI
$18,786-$159,703/year (est.)
Summary This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval,...
Detroit, MI
$66K-$80K / yr. (est.)
At Henry Ford Hospital, all nurses strive to provide exceptional patient care every day. They are encouraged to participate in quality assurance activities, research and shared governance to make a difference in the care given to patients and families. Henry Ford Nursing uses evidence-based...
Detroit, MI
$48,198-$80,331/year (est.)
This is a fulltime, remote, telework position. Schedule is Monday - Friday 8am - 5pm EST with occasional, rotating weekends and holidays.Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and...
Detroit, MI
$18,818-$159,703/year (est.)
Req ID: 72331BR Job Description Utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program. Requires an RN with unrestricted active license. Fundamental Components included but are not limited to: Utilizes clinical experience and...
Detroit, MI
$18,786-$159,703/year (est.)
Responsibilities: Provide clinical and pharmacoeconomic support and recommendations to the Manager of Clinical Operations relating to formulary, criteria, and P&Ps that ensure safe, efficacious, and cost-effective prescribing and drug use Maintain drug pipeline for pharmacy benefits and medication...
Detroit, MI
$18,786-$159,703/year (est.)
Responsibilities: Oversee the queue workload needs on a concurrent basis including the inpatient authorization queues and the inpatient fax queues in the UM department to concurrently prioritize self-assignment for greatest impact on department function Support orientation program for UM staff by...
Detroit, MI
$18,786-$159,703/year (est.)
Responsibilities: Oversee the queue workload needs on a concurrent basis including the inpatient authorization queues and the inpatient fax queues in the UM department to concurrently prioritize self-assignment for greatest impact on department function Support orientation program for UM staff by...
Detroit, MI
$18,786-$159,703/year (est.)
The Nurse Analyst is responsible for assessing the medical appropriateness of proposed or performed hospital/medical/surgical services in accordance with established criteria. In some cases, only broad policy exists which will require the incumbent to exercise independent judgement based on sound...
Detroit, MI
$18,818-$159,703/year (est.)
A new 36 hour position for a Access Care RN is available at the Henry Ford Hospital in midtown Detroit. This position performs utilization management processes to approved clinical screening guidelines to evaluate and recommend patient admissions. May recommend if the patient is a candidate for...
Detroit, MI
$18,786-$159,703/year (est.)
General Description: Utilization review experience is preferred. Must have active Michigan RN License. Hours may vary from 8-4: 30 or 8: 30-5p. Will need to work every third Saturday with another day off during the week. Must have coding/billing experience and previous utilization management or...
Detroit, MI
$18,818-$159,703/year (est.)
Responsibilities: Develop 60 day orientation/training schedule for new clinical utilization management staff Monitor staff progress weekly and update training orientation outline accordingly Provide at least weekly written progress reports to manager and updated training outline Discuss issues or...