3w
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RN UTILIZATION MANAGEMENT SPECIALIST
Saginaw, Michigan, United States
OnsitePart Time
Active Michigan RN license required. Preferred 3 years utilization management experience. Must demonstrate clinical competence, denial/appeals and utilization management skills, strong written/verbal communication, and solid computer skills.
InterQual, Epic, EHR
1mo
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Utilization Specialist
Battle Creek, Michigan, United States
OnsiteFull Time
2+ YOEHigh school diploma required; clinical experience or 2+ years working with the facility population; preferred degrees in social work/behavioral health/nursing; preferred licensure (LPN/RN/LMSW/LCSW/LPC); CPR and de-escalation/restraint certification required.
2w
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Utilization Management Coordinator (MI, Ludington)
Ludington, Michigan, United States
OnsiteFull Time
Perform retrospective monitoring and audits of utilization management, aggregate and analyze data to support decisions, apply QI principles, and facilitate UM committees and regional/state workgroups.
3w
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Utilization Review Supervisor (PCN 1547)
Troy, Michigan, United States
$70k-$88k/yr HybridFull Time
5+ YOEMaster's in a mental health field, Michigan clinical license (Psychologist, Social Worker, Counselor, or Marriage and Family Therapist), 5+ years serving people with serious behavioral health needs, supervisory experience preferred, knowledge of Medicaid and utilization review.
1w
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Utilization Management Specialist
Southfield, Michigan, United States
HybridPart Time
High school diploma or equivalent; familiarity with insurance websites and electronic medical record work queues; clerical support, phone triage and problem solving skills; preferred 2 years healthcare experience and post-high-school training.
Electronic Medical Record
1mo
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Utilization Management Clerk
Lansing, Michigan, United States
OnsiteFull Time
1+ YOE1 year emergency or correctional service experience; understanding of medical and pharmacological terminology; CMA or CMAA certificate required; satisfactory background check and adherence to confidentiality and health policies.
5d
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Access-Utilization Manager
Port Huron, Michigan, United States
$78k/yr OnsiteFull Time
3+ YOE2+ MgmtMaster's in social work or related field, 3+ years behavioral health experience, 2 years supervisory experience, proficiency with EHR, knowledge of ASAM and DSM-5, valid Michigan driver, organized.
Peter Chang Enterprise (PCE) Electronic Health Record
3mo
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Utilization Management Program Manager-RN
Arizona or Arkansas or Connecticut or Florida or Georgia or Idaho or Indiana or Iowa or Kansas or Kentucky or Louisiana or Michigan or Mississippi or Missouri or Montana or Nebraska or Nevada or New Hampshire or New Mexico or North Carolina or Oklahoma or Oregon or Pennsylvania or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or West Virginia or Wisconsin
RemoteFull Time
5+ YOEUnencumbered Oregon RN within 90 days, 1 year clinical nursing plus 4 years health-plan utilization management, experience with managed care, data analysis, quality management, and electronic documentation.
Microsoft Office, EPIC, Clinical Care Advanced
1mo
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Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote
Troy, Michigan, United States
RemoteFull Time
3+ YOERHIT, RHIA, or related coding certification required; minimum 3+ years clinical experience preferred; utilization management/case management experience preferred; Monday–Friday daytime availability.
InterQual
1mo
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Behavioral Health Utilization Management Specialist
Hastings or Michigan
$58k/yr RemoteFull Time
Master's in a behavioral health field, active Michigan clinical licensure (e.g., LMSW, LPC), prior utilization management/managed care experience, strong clinical judgment, communication, and ability to work independently in a remote setting.
electronic health records, UM software systems
2mo
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Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote in Troy, Michigan
Troy, Michigan, United States
RemoteFull Time
3+ YOERHIT/RHIA or related coding certification; 3-5 years clinical experience; utilization management experience preferred.
5d
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Utilization Management Behavioral Health Professional
Virginia or Texas or Tennessee or South Carolina or Pennsylvania or West Virginia or New York or Wisconsin or North Carolina or New Jersey or Massachusetts or Louisiana or Michigan or Kentucky or Maryland or Kansas or Indiana or Illinois or Georgia or Florida or Arkansas or Alabama or Vermont or Rhode Island or Maine or Delaware or Connecticut
$65k-$89k/yr RemoteFull Time
1+ YOERequires behavioral health clinical licensure (RN/LCSW/LPC/LMFT/LCP/clinical psychologist), 1+ year post-degree clinical and 1+ year managed care experience, Microsoft Office proficiency, and remote work capabilities.
Microsoft Word, Microsoft Excel, Microsoft PowerPoint, HireVue
2mo
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Group Director - Utilization Review
Detroit, Michigan, United States
OnsiteFull Time
5+ YOE5+ MgmtLead utilization review and case management strategy; oversee UM operations; ensure regulatory compliance; multi-site leadership; healthcare administration experience.
CarePort, MIDAS, Tableau, Excel, PowerPoint
2mo
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Senior Utilization Management Compliance and Accreditation Specialist
Okemos or Detroit
HybridFull Time
7+ YOEBachelor's degree in business administration or public administration; 7 years in NCQA/URAC quality management or compliance auditing; strong data analysis and communication skills; MS Office proficiency.
Microsoft Office
1mo
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Utilization Management Case Manager
Auburn Hills, Michigan, United States
OnsiteFull Time
2+ YOEBachelor's in social work, psychology, counseling, or nursing required; master's preferred. Limited or full license (e.g., lbsw, rn, llmsw, lpc, lmft). Minimum 2 years post‑graduate psychiatric or substance abuse experience; utilization review experience preferred.
2mo
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Unit Operator - NH (Monroe PP)
Monroe, Michigan, United States
OnsiteFull Time
5+ YOEFive years operating experience (or four plus qualification), HS diploma or higher, knowledge of PPO-77 and boiler/turbine control systems, First Aid/CPR within 18 months, DTE Basic Electrical Certificate, CRT/data entry skills.
DCS control system, Protective Tagging System PPO-77, CRT, spreadsheets, graphics, database managers
1mo
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Locate Technician - Grand Rapids, MI
Grand Rapids, Michigan, United States
FieldFull Time
High school diploma or equivalent, valid driver license, pass background and drug screen, ability to walk several miles and lift up to 25 lbs, outdoor work in all weather; on-the-job training provided.
laptop
1w
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Seasonal Truck Driver
Petoskey, Michigan, United States
FieldFull Time, Temporary
CDL Class B with HAZMAT, tanker, and air brake endorsements and Medical Examiner's Certificate; ability to lift 50–75 lbs; English proficiency; background check and drug screen required.
handheld terminal
2w
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Utilization Management RN III
Arkansas or Arizona or Florida or Georgia or Iowa or Illinois or Kansas or Kentucky or Michigan or Minnesota or Missouri or North Dakota or Nebraska or Oklahoma or South Dakota or Tennessee or Texas or Virginia or Wisconsin
$70k-$105k/yr RemoteFull Time
5+ YOEBachelor's or equivalent and 5 years experience beyond degree; active LPN or RN license required (active unrestricted RN required); clinical assessment, UM and appeals experience preferred.
3mo
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Physician Advisor- Utilization Management & Clinical Documentation Integrity- ONSITE
Athens or Livonia or Georgia or United States
OnsiteFull Time, Contract
5+ YOEMD or DO, board certified, active Georgia medical license, 5+ years clinical hospital experience, leadership and people management skills, strong EMR and data/analytics capability, knowledge of utilization review and clinical documentation.
EMR
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