In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
In this position you will be reviewing patient charts to determine if pre-elective surgical cases ... Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES ...
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Director of Utilization Management
Troy, MI · On-site +1
$160K - $160K/yr
Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Utilization Management Coordinator
Troy, MI · On-site +1
$19/hr
Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes * Verify ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Utilization Management Coordinator
Troy, MI · On-site +1
$19/hr
Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes * Verify ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Previous experience in quality assurance, utilization review, or clinical leadership * Experience ... Remote work opportunity * Health, dental, and vision insurance * Paid Time Off * Paid holidays ...
Quick apply
Previous experience in quality assurance, utilization review, or clinical leadership * Experience ... Remote work opportunity * Health, dental, and vision insurance * Paid Time Off * Paid holidays ...
RN Care Manager - PRN
Almont, MI · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
RN Care Manager - PRN
Almont, MI · Remote
$41.20 - $62.17/hr
Demonstrated experience in case management, utilization review, value-based care, and/or discharge ... If applying for a remote or hybrid role, this includes remote work expectations related to ...
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
Auditor, Healthcare Services (Remote in MI)
Detroit, MI · Remote
$26.41 - $51.49/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Auditor, Healthcare Services (Remote in MI)
Detroit, MI · Remote
$26.41 - $51.49/hr
... review experience. Mastery of Microsoft Office, especially Excel, PowerPoint will also be skill ... Essential Job Duties • Performs audits in utilization management, care management, member ...
Health & Social Services RN - Remote in Michigan
Southfield, MI · Remote
$29 - $52/hr
Experience in utilization review, concurrent review or risk management * Background in managing populations with complex medical or behavioral needs * Acute care experience *All Telecommuters will be ...
Health & Social Services RN - Remote in Michigan
Southfield, MI · Remote
$29 - $52/hr
Experience in utilization review, concurrent review or risk management * Background in managing populations with complex medical or behavioral needs * Acute care experience *All Telecommuters will be ...
Remote Community Based Clinical Coordinator - Care Manager - Charlevoix, County
Boyne City, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Charlevoix, County
Boyne City, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Cheboygan County, MI
Cheboygan, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Cheboygan County, MI
Cheboygan, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Otsego County, MI
Daggett, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Otsego County, MI
Daggett, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Emmet County, MI
Petoskey, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Emmet County, MI
Petoskey, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Ontonagon County, MI
Ontonagon, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Ontonagon County, MI
Ontonagon, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Gogebic County, MI
Ironwood, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Gogebic County, MI
Ironwood, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Iron County, MI
Iron River, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Iron County, MI
Iron River, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Dickinson County, MI
Iron Mountain, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager - Dickinson County, MI
Iron Mountain, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
New
Remote Community Based Clinical Coordinator - Care Manager- Luce County, MI
Newberry, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
Remote Community Based Clinical Coordinator - Care Manager- Luce County, MI
Newberry, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
Remote Community Based Clinical Coordinator - Care Manager- Chippewa County, MI
Sault Sainte Marie, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
Remote Community Based Clinical Coordinator - Care Manager- Chippewa County, MI
Sault Sainte Marie, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
Remote Community Based Clinical Coordinator - Care Manager - Mackinac County, MI
Saint Ignace, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
Remote Community Based Clinical Coordinator - Care Manager - Mackinac County, MI
Saint Ignace, MI · On-site +1
$29.72/hr
... utilization, past and present treatment plan and services, prognosis, short and long-term goals ... reviewing statistical data Other Requirements: Valid Driver's License with proof of insurance ...
Remote Hca Utilization Review information
What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?
| Aspect | Remote Hca Utilization Review | Remote Hca Case Manager |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications, such as RN or licensed healthcare professional | Often requires RN, social work, or case management certifications |
| Work Environment | Primarily reviewing medical necessity and insurance coverage remotely | Managing patient cases, coordinating care, and discharge planning remotely |
| Employer & Industry Usage | Used by health insurance companies, healthcare providers, and utilization review organizations | Employed by hospitals, insurance companies, and healthcare organizations |
Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.
What are popular job titles related to Remote Hca Utilization Review jobs in Michigan?
For Remote Hca Utilization Review jobs in Michigan, the most frequently searched job titles are:
- Utilization Management
- Weekend Physician Advisor Utilization Review
- Per Diem Utilization Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- No Experience Utilization Management Nurse
- Utilization Review Specialist
- No Experience Utilization Review Nurse
- Seasonal Remote Hedis Review Nurse
- Evening Utilization Review Nurse
- Optum Clinical Claim Review Nurse
What job categories do people searching Remote Hca Utilization Review jobs in Michigan look for?
The top searched job categories for Remote Hca Utilization Review jobs in Michigan are:
- Remote Dental Utilization Review
- Commission Authorization Utilization Review Bcba
- Temporary Aetna Utilization Review Nurse
- Therapy Utilization Review
- Registered Nurse Case Review
- Remote Weekend Utilization Review
- Remote International Utilization Review Nurse
- Optum Utilization Review Nurse
- Remote Aetna Utilization Review Nurse
- Authorization Utilization Review Bcba
What cities in Michigan are hiring for Remote Hca Utilization Review jobs?
Cities in Michigan with the most Remote Hca Utilization Review job openings:
Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote
Troy, MI • On-site, Remote
Full-time
Re-posted 21 days ago
Henry Ford Health rating
7.0
Based on 565 frontline employees who took The Breakroom Quiz
415th of 887 rated healthcare providers
Job description
In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient. You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
CERTIFICATIONS/LICENSURES REQUIRED:
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
- RHIT, RHIA, or related coding certification required.
- Minimum 3-5 years of clinical experience preferred.
- Previous utilization management or case management experience preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
- RHIT, RHIA, or related coding certification required.
What Henry Ford Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Henry Ford Health
Sourced by ZipRecruiter
Henry Ford Health provides a full continuum of services from Primary and Preventative care, to Complex and Cpecialty care, Health Insurance, a full suite of home health offerings, Virtual care, Pharmacy, Eye care and other Healthcare retail. It is one of the Nation’s leading Academic Medical Centers, recognized for Clinical excellence in Cancer care, Cardiology and Cardiovascular Surgery, Neurology and Neurosurgery, Orthopedics and Sports medicine, and Multi organ transplants. Consistently ranked among the top five NIH funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of Health Professionals, Henry Ford Health trains more than 4,000 Medical students, Residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most Diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Detroit, MI, US
Year founded
1915