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Part Time Insurance Utilization Review Jobs in Michigan

MDS Part Time RN

West Bloomfield, MI · On-site

$33 - $43.25/hr

Requirements Part Time RN MDS Float - 3 days a week Facility: MediLodge of West Bloomfield We ... Facility contact for insurance updates * Facilitate the weekly utilization review of patients on ...

... utilization review RNs, revenue cycle, and payers as needed to coordinate processes and research ... insurance, an acceptable driving record and reliable transportation. Preferred Qualifications

NP/PA Surgery - Urology

Ann Arbor, MI · On-site

$106K - $137K/yr

Employment Type: Part time Shift: Rotating Shift Description: POSITION PURPOSE The Urology NP/PA ... and utilization review processes. In partnership with the supervising physician, the NP/PA ...

Showing results 21-40

Part Time Insurance Utilization Review information

What is the difference between Part Time Insurance Utilization Review vs Part Time Claims Reviewer?

AspectPart Time Insurance Utilization ReviewPart Time Claims Reviewer
CredentialsTypically requires insurance or healthcare-related certificationsOften requires insurance or claims processing certifications
Work EnvironmentHealthcare settings, insurance companies, or third-party administratorsInsurance companies, claims processing centers, or third-party administrators
Job FocusEvaluating medical necessity and appropriateness of servicesReviewing and processing insurance claims for accuracy and coverage

Part Time Insurance Utilization Review and Part Time Claims Reviewer roles both involve insurance industry work, but focus on different aspects. Utilization review centers on assessing medical necessity, while claims reviewers handle processing and verifying claims. Understanding these differences helps job seekers find the right fit based on their skills and interests.

What are the most commonly searched types of Insurance Utilization Review jobs in Michigan?

The most popular types of Insurance Utilization Review jobs in Michigan are:

What cities in Michigan are hiring for Part Time Insurance Utilization Review jobs?

Cities in Michigan with the most Part Time Insurance Utilization Review job openings:

Nursing Night Shift Supervisor - Full Time

Thornapple Manor

Hastings, MI

Full-time, Part-time, Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 10 days ago


Job description

Shift:

  • 6:00PM to 6:30AM - Full Time Schedule including every third weekend.

Wages:

  • Hourly wage range based on experience
  • Additional $3.40 per hour Direct Care Wage through September 2025
  • Additional $2.00 per hour for shift differential

Benefits:

  • Accrue generous Paid Time Off
  • MERS Defined Benefit Pension program
  • MERS 457 Supplemental Program
  • Longevity Bonuses
  • Free Short Term Disability
  • Generous benefits package including Medical, Dental, Vision and Voluntary Life Insurance for both part-time and full-time employees
  • Referral Bonuses

JOB TITLE:              NURSING SUPERVISOR

REPORTS TO:         DIRECTOR OF NURSING

JOB SUMMARY:

           The primary purpose of your job position is to supervise the day-to-day nursing activities of the facility during your tour of duty.  Such supervision must be in accordance with current federal, state, and local standards, guideline, and regulations that govern our facility, and as may be required by the Director of Nursing Services, to ensure that the highest degree of quality care is maintained at all times.

DELEGATION OF AUTHORITY:

            As Nurse Supervisor you are delegated the administrative authority, responsibility, and accountability necessary for carrying out your assigned duties.

JOB FUNCTIONS:

            Every effort has been made to make your job description as complete as possible.  However, it in no way states or implies that these are the only duties you will be required to perform.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or is a logical assignment to the position.

MAJOR DUTIES AND RESPONSIBILITIES:

Administrative Functions:

  • Assist the Assistant Director of Nursing Services in directing the day-to-day functions of the nursing activities in accordance with current rules, regulations, and guidelines that govern the long-term care facility.
  • Participate in developing, maintaining, and updating written policies and procedures that govern the day-to-day functions of the nursing service department.
  • Ensure that reference material (i.e., PDR’s, Federal and State Regulations, etc.) maintained at the nurses’ stations is current.  Recommend written material that will assist the nursing service department in meeting the day-to-day needs of the resident.
  • Ensure that the Nursing Service Procedures Manual is current and reflects the day to day nursing procedures performed in this facility.
  • Ensure that all nursing service personnel comply with the procedures set forth in the Nursing Service Procedures Manual.
  • Make written and oral reports/recommendations to the Director as necessary/required, concerning the operation of the nursing service department.
  • Periodically review the department’s policies, procedure manuals, job descriptions, etc.  Make recommendations for revisions to the Director.
  • Assist in developing methods for coordinating nursing services with other resident services to ensure the continuity of the residents’ total regimen of care.
  • Ensure that all nursing service personnel are in compliance with their respective job descriptions.
  • Participate in the development, maintenance and implementation of the facility’s quality assurance program for the nursing service department.
  • Participate in surveys (inspections) made by authorized government agencies as requested by the Administrator or Director of Nursing Services.
  • Periodically review the resident’s written discharge plan.  Participate in the updating of the resident’s written discharge plan as required.
  • Assist the Director in planning the nursing services portion of the resident’s discharge plan as necessary.
  • Meet with the nursing staff, as well as support personnel, in planning the department’s services, programs, and activities.
  • Admit, transfer, and discharge residents as required.
  • Complete accident/incident reports as necessary.
  • Interpret the department’s policies and procedures to personnel, residents, visitors, and government agencies as required.
  • Perform administrative duties such as completing medical forms, reports, evaluations, studies, charting, etc., as necessary.

Committee Functions:

  • Attend various committee meetings of the facility (i.e., Infection Control, Policy Advisory, Pharmaceutical, Quality Assessment, etc.) as required.
  • Assist in preparing written and/or oral reports of the nursing service programs and activities to submit to such committee(s) as directed.
  • Provide information to the Quality Assurance and Assessment Committee as requested.
  • Participate in developing the agenda for the Care Plan Committee meetings as necessary.
  • Participate in regularly scheduled reviews of the discharge plans and make such plans available to the Utilization Review Committee as required or as may be necessary.
  • Attend and participate in the Utilization Review Committee functions as required or as may be necessary.
  • Implement recommendations from established committees as instructed by the Director.

Personnel Functions:

  • Ensure that a sufficient number of licensed practical and/or registered nurses are available for your tour of duty to ensure that quality care is maintained.
  • Ensure that a sufficient number of certified nursing assistants are available for your tour of duty to ensure that routine nursing care is provided to meet the daily nursing care needs of each resident.
  • Develop work assignments, and/or assist in completing and performing such tasks.
  • Delegate to each Charge Nurse the administrative authority, responsibility, and accountability necessary to perform his/her assigned duties.
  • Ensure that all nurse aide trainees are under the direct supervision of a licensed nurse.
  • Make daily rounds of the nursing service department to ensure that all nursing service personnel are performing their work assignments in accordance with acceptable nursing standards.  Report findings to the Director.
  • Monitor absenteeism to ensure that an adequate number of nursing care personnel are on duty at all times.  Report problem areas to the Director.
  • Ensure that established policies and procedures, including dress codes, are followed by all departmental personnel.
  • Review complaints and grievances made or filed by department personnel.  Make appropriate reports to the Director as required or as may be necessary.
  • Develop and maintain a good working rapport with inter-department personnel, as well as other departments within the facility to ensure that nursing services and activities can be adequately maintained to meet the needs of the residents.
  • Create and maintain an atmosphere of warmth, personal interest and positive emphasis, as well as a calm environment throughout the unit and shift.
  • Meet with your shift on a regularly scheduled basis to assist in identifying and correcting problem areas and/or to assist in the improvement of services.
  • Review and evaluate your department’s work force and make recommendations to the Director.
  • Participate in employee performance evaluations, determining your shift’s staffing requirements, and making recommendations to the Director concerning employee dismissals, transfers, etc.
  • Ensure that disciplinary action is administered fairly and without regard to race, color, creed, national origin, age, sex, religion, handicap, or marital status.

Nursing Care Functions:

  • Inform nursing service personnel of new admission, their expected time of arrival, room assignment, etc.
  • Ensure that rooms are ready for new admissions.
  • Greet newly admitted residents upon admission.  Escort them to their rooms as necessary.
  • Make rounds with physicians as necessary.
  • Encourage attending physicians to record and sign progress notes, physicians’ orders, etc., on a timely basis and in accordance with current regulations.
  • Consult with the resident, his/her family, and the resident’s physician in planning the resident’s care, treatment, rehabilitation, etc., as necessary.
  • Notify the resident’s attending physician and next-of-kin when there is a change in the resident’s condition.
  • Visit residents on a daily basis in order to observe and evaluate each resident’s physical and emotional status.
  • Ensure that direct nursing care be provided by a licensed nurse, a certified nursing assistant, and/or a nurse aide trainee qualified to perform the procedure.
  • Review nurses’ notes to ensure that they are informative and descriptive of the nursing care being provided, that they reflect the resident’s response to the care, and that such care is provided in accordance with the resident’s wishes.
  • Provide direct nursing care as necessary.
  • Start IVs, obtain sputum, urine and other specimens for lab tests as ordered.
  • Take TPRs, blood pressures, etc., as necessary.
  • Admit, transfer and discharge residents as necessary.
  • Report problem areas to the Director.  Assist in developing and implementing corrective action.
  • Keep the Director informed of the status of residents and other related matters through written/oral reports.
  • Assist the Charge Nurse in monitoring seriously ill residents.
  • Authorize the use of restraints when necessary and in accordance with our facilities policies and procedures.
  • Ensure that all RNs and LPNs on your shift comply with written procedures for the administration, storage, and control of medications and supplies.
  • Monitor medication passes and treatment schedules to ensure that medications are being administered as ordered and that treatments are provided as scheduled.
  • Review medication cards for completeness of information, accuracy in the transcription of physician orders, and adherence to stop order policies.
  • Inspect the nursing service treatment areas daily to ensure that they are maintained in a clean and safe manner.
  • Ensure that residents who are unable to call for help are checked frequently.
  • Meet with residents, and/or family members, as necessary.  Report problems to the Director.
  • Assist in arranging transportation for discharged residents as necessary.
  • Inform family members of the death of the resident.
  • Call funeral homes when requested by the family.

Staff Development:

  • Participate in developing, planning, conducting, and scheduling in-service training classes that provide instructions on “how to do the job”, and ensure a well-educated nursing service department.
  • Develop, implement, and maintain an effective orientation program that orients the new employee to your shift, its policies and procedures, and to his/her job position and duties.
  • Provide leadership training that includes the administrative and supervisory principles essential for your Charge Nurses.
  • Encourage your Charge Nurses to attend and participate in outside training programs.  Schedule times as appropriate.
  • Assist the training coordinator in developing annual mandated OSHA and CDC in-service training programs for hazard communication, TB management, and blood-borne pathogens standard.
  • Assist the training coordinator in developing advance directive in-service training programs for the staff and the community.
  • Assist support services in developing, implementing, and conducting in-service training programs that relate to the nursing service department.
  • Assist the training coordinator in the development of in-service training programs for the nursing staff.  Ensure that these programs meet the continuing education requirements which allow licensed personnel (e.g., RNs, LPNs, CNAs, etc.) to keep their license on an active status.
  • Attend and participate in continuing education programs designed to keep you abreast of changes in your profession, as well as to maintain your license on a current status.

Safety and Sanitation:

  • Assist the Director and/or Infection Control Coordinator in identifying, evaluating, and classifying routine and job-related functions to ensure that tasks in which there is potential exposure to blood/body fluids are properly identified and recorded.
  • Ensure that an adequate supply of personal protective equipment is on hand and readily available to personnel who perform procedures that involve exposure to blood or body fluids.
  • Ensure that personnel follow established procedures for the use and disposal of personal protective equipment.
  • Monitor your shift’s personnel to ensure that they are following established safety regulations in the use of equipment and supplies.
  • Ensure that all nursing service personnel comply with established departmental policies and procedures.
  • Ensure that nursing work areas (i.e., nurses’ stations, medicine preparation rooms, etc.) Are maintained in a clean and sanitary manner.
  • Ensure that all resident care rooms, treatment areas, etc., are maintained in a clean, safe, and sanitary manner.
  • Ensure that nursing service personnel follow established hand-washing procedures.
  • Ensure that nursing service personnel participate in and conduct all fire safety and disaster preparedness drills in a safe and professional manner.
  • Participate in the implementation and maintenance of the infection control program for monitoring communicable and/or infectious diseases among the residents and personnel.
  • Ensure that nursing service personnel follow established infection control procedures when isolation precautions become necessary.
  • Participate in the implementation and maintenance of the procedure for reporting hazardous conditions or equipment.
  • Ensure that all personnel wear and/or use safety equipment and supplies (e.g., back brace, lifter, etc.) when lifting or moving residents.

Equipment and Supply Functions:

  • Recommend to the Director the equipment and supply needs of the department.
  • Ensure that an adequate stock level of medications, medical supplies, equipment, etc., is mai...