Drug Utilization Review Specialist

Under the general supervision of the Director of Utilization Management for the Detroit Wayne Integrated Health Network (DWIHN), Clinical Specialists - Utilization Management are responsible for providing utilization management and review of services to consumers. PRINCIPAL DUTIES AND RESPONSIBILITIES: Provides Utilization Management and review of services...

Title: RN Review Analyst Location: Detroit, MI (Remote - must be local to Michigan) Duration: 11 -month contract with the possibility of extending or converting to full time. Role Type: W2 Contract Engagement Pay Rate: 40/HR without benefits Pay Rate: 38/HR with benefits. Pay rate with benefits and PTO: 36/HR (16 vacation days per calendar year) Role...

Responsible for the review of precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual criteria. Required to enter or reference data via PC, collaborate with facilities, providers and Medical Directors. Must have excellent written and oral communication skills. Other related skills may be required...

Responsible for the review of precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual criteria. Required to enter or reference data via PC, collaborate with facilities, providers and Medical Directors. Must have excellent written and oral communication skills. Other related skills may be required...

Title: RN Review Analyst Location: Detroit, MI (Remote - must be local to Michigan) Duration: 8 month contract with the possibility of extending or converting to full time. Role Type: W2 Contract Engagement Pay Rate: 40/HR without benefits Pay Rate: 38/HR with benefits. Pay rate with benefits and PTO: 36/HR Role Type: Exempt Engagement Description –...

Monitor construction schedule, cost and quality to ensure project goals are met * Works with superintendent to direct and coordinate personnel to ensure project progresses safely, on schedule, within all quality standards, and within prescribed budget * Manage multiple subcontractors for utility work and coordinate with various disciplines to ensure project...

Title: RN Review Analyst Want to make an application Make sure your CV is up to date, then read the following job specs carefully before applying.Location: Detroit, MI (Remote - must be local to Michigan) Duration: 8 month contract with the possibility of extending or converting to full time. Role Type: W2 Contract Engagement Pay Rate: 40/HR without...

With a career at HMSHost, you really benefit! We Offer Health, dental and vision insurance Generous paid time off (vacation, flex or sick) Holiday pay Meal and Transportation Benefits *401(k) retirement plan with company match *Company paid life insurance *Tuition reimbursement Employee assistance program Training and exciting career growth opportunities...

Registered Nurse-Review Analyst Engagement Description - Perform prospective, concurrent and retrospective review of inpatient services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers and facilities Top 3 Required Skills/Experience - • Bachelor's degree in...

Job Description: Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through...

Job Description: Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through...

Job Description Use established medical policy and guidelines to perform prospective, concurrent, and retrospective medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length of stay, including appeal requests initiated by providers, facilities and members. Will coordinate care through the...

Job Summary:As a Healthcare Utilization Management Assistant at McLaren USA, you will play a vital role in ensuring the efficient operation of our Integrated Care Management department. Your primary responsibility will be to provide assistance to the Utilization Manager RN in coordinating patient admission and continued stay reviews. Additionally, you will...

Job Description Use established medical policy and guidelines to perform prospective, concurrent, and retrospective medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length of stay, including appeal requests initiated by providers, facilities and members. Will coordinate care through the...

Apply now and our proprietary system will quickly have you in front of a live recruiter. The Opportunity Description We're looking for a RN - Review Analyst, working in Insurance industry in Detroit, Michigan, United States. Use established medical policy and guidelines to perform prospective, concurrent, and retrospective medical necessity review of...

Family Preservation SpecialistMake a Positive Change in Families LivesFamilies First Workers are dedicated to supporting families in need. As a Family Preservation Specialist, you will work closely with families to provide intensive, short-term or long-term in-home crisis intervention and family education. This vital role involves working with a two-family...

About the Role:Central City Health is seeking an experienced Mental Health Specialist - Physician Leader to join our team. As a key member of our multidisciplinary care team, you will provide comprehensive psychiatric evaluations and medication reviews to patients in need of mental health services.Key Responsibilities:Evaluate patient need for psychotropic...

Position Summary: Responsible for providing assistance to the Utilization Manager (UM) RN in the coordination of patient admission and continued stay reviews, as well as, performing clerical functions to ensure the efficient operation of the ICM department. Essential Functions and Responsibilities as Assigned: Collaborates with the UM RN to determine the...

Position DescriptionEngineer Principal Specialist is responsible for managing and optimizing the life cycle of physical assets to ensure they serve the intended purpose efficiently and effectively. This include the development of the strategy and business process around it. Builds and maintains effective relationships with key internal and/or external...

As a key member of Pan Asia Resources' Technology Division, the Field Service Specialist plays a vital role in the delivery of technical support services to users across the organization.The successful candidate will be responsible for providing timely, accurate, and efficient technical support to users, utilizing the district service management tool.The...