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Care Coordination Works with Nursing and hospital leadership to ensure Patient Care Conferences and Complex Case Review processes are in place to promote timely and appropriate throughputParticipates in daily bed management meeting to support timely and effective patient placement and transfer within the hospital. Follows the InterQual Inter-rater Reliability (IRR) Policy to determine initial and yearly competency for all employees performing InterQual reviewsDevelops action plan for case managers that fail to meet the IRR acceptable “match” rate to ensure improvement in the accurate application of InterQual criteria.

Central Business Solutions

Director Case Management [Full Time / Permanent]

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ADAPTED_NOW

Oversees hospital utilization performance improvement and operational management of the site Case Management Department to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. Leadership skills including demonstrated willingness to pursue leadership roles with increasing levels of accountability, comfort with decision-making responsibilities, coaching, teaching and counseling skills, and the ability to inspire and build confidence in others and to forge alliances and garner support.

DMC Receiving Hospital

Director - Case Management

Tenet Healthcare Monster

FULL_TIME

The Director Case Management is responsible for overseeing utilization management, transition management, care coordination, compliance, and operational leadership of the hospital’s Case Management Department. The ideal candidate will possess strong acute hospital case management leadership experience with expertise in utilization review, payer management, care coordination, and interdisciplinary collaboration.

Veracity Ventures Inc.

Director Case Management

The NP/PA carries out physician orders and maintains the continuum of care through the coordination and integration of patients on acute pain service, guided by progress notes, consults, care plans, critical pathways, managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. Assessment and discontinuation of epidural and regional anesthesia catheters Completion of daily hospital work rounds including charting of progress notes, order entry and modification as required under the direction of the supervising physician.

Trinity Health is one of the largest not-for-profit, faith-based health care systems in the nation. It is a family of 121,000 colleagues and nearly 36,500 physicians and clinicians caring for diverse communities across 27 states. Nationally recognized for care and experience, the Trinity Health system includes 101 hospitals, 126 continuing care locations, the second largest PACE program in the country, 136 urgent care locations and many other health and well-being services. In fiscal year 2023, the Livonia, Michigan-based health system invested $1.5 billion in its communities in the form of charity care and other community benefit programs.

Trinity Health

NP / PA - Acute Pain

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Insight Institute of Neuroscience & Neurosurgery (IINN) aims to advance, challenge, and revolutionize neurosciences and medicine through scientific research and advanced technology, driven by a passion to help others regardless of any obstacles and challenges that may lie ahead. A Nurse’s primary responsibilities include delivering care to patients, providing health education to patients, and working with an interdisciplinary team to create a rehabilitation plan for patients.

Insight

Registered Nurse (Psych Nurse)

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Performs concurrent and retrospective utilization management-related activities and functions to ensure that appropriate data are tracked, evaluated, and reported including Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON) completion. Assists with the coordination post discharge placement and services by making referrals, confirming specific placement and service arrangements, processing, organizing and obtaining insurance verification and/or prior authorization from insurance companies for discharge arrangements.

McLaren Health Care Corp

Integrated Care Management Administrative Assistant

Routinely communicates with payers, patients/family caregivers, physicians, the interdisciplinary team, post-acute and community-based care providers to facilitate coordination of care and to enhance a seamless transition from hospital setting to the appropriate alternative level of care. Responsible for managing a case load of patients that includes facilitating utilization management, and/or care coordination during the patient’s stay, planning and expediting plans for safe and effective discharge and transition to the appropriate level of care and setting needed after hospitalization.

Corewell Health

RN Care Coordinator

Routinely communicates with payers, patients/family caregivers, physicians, the interdisciplinary team, post-acute and community-based care providers to facilitate coordination of care and to enhance a seamless transition from hospital setting to the appropriate alternative level of care. Responsible for managing a case load of patients that includes facilitating utilization management, and/or care coordination during the patient's stay, planning and expediting plans for safe and effective discharge and transition to the appropriate level of care and setting needed after hospitalization.

RN Care Coordinator Rehab inpatient

This individual's responsibility will include the following activities: a) complex psycho-social transition planning assessment and reassessment and intervention, b) assistance with adoptions, abuse and neglect cases, including assessment, intervention and referral as appropriate to local, state and /or federal agencies, c) care coordination, d) implementation or oversight of implementation of the transition plan, e) leading and/or facilitating multi-disciplinary patient care conferences including Complex Case Review, f) making appropriate referrals to other departments, g ) communicating with patients and families about the plan of care, h) collaborating with physicians, office staff and ancillary departments, i) assuring patient education is completed to support post-acute needs , j) timely complete and concise documentation in Case Management system, k ) maintenance of accurate patient demographic and insurance information, l) and other duties as assigned. The Social Worker is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination.

DMC Sinai-Grace Hospital

Social Worker - Case Management

This individual's responsibility will include the following activities: a) complex psycho-social transition planning assessment and reassessment and intervention, b) assistance with adoptions, abuse and neglect cases, including assessment, intervention and referral as appropriate to local, state and /or federal agencies, c) care coordination, d) implementation or oversight of implementation of the transition plan, e) leading and/or facilitating multi-disciplinary patient care conferences including Complex Case Review, f) making appropriate referrals to other departments, g ) communicating with patients and families about the plan of care, h) collaborating with physicians, office staff and ancillary departments, i) assuring patient education is completed to support post-acute needs, j) timely complete and concise documentation in Case Management system, k ) maintenance of accurate patient demographic and insurance information, l) and other duties as assigned. The Social Worker is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination.

Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans. Since 2003, Tenet's Commitment to Quality has improved the quality of medical care and patient safety at its hospitals and other businesses by evaluating processes and promoting best practices. As the world in which Tenet operates continues to change, Tenet's Commitment to Quality will remain focused on quality, the growing quality gap relative to top performers in the industry, and the fact that payers and employees use quality as a distinguishing factor. Visit the Quality Care page for more information. Tenet has taken the lead in addressing the needs of the uninsured through its Compact With Uninsured Patients. Established in 2003, the Compact focuses on treating patients without insurance fairly and with respect during and after their treatment, regardless of their ability to pay. Tenet also is committed to working with its patients through financial counseling and alternative payment options.

Tenet Healthcare Corp

Clinical Social Worker Case Management

Responsibilities: We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right. Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery.

Select Specialty Hospital - Ann Arbor

Case Manager / PRN ( RN / RT / SW / LPN )

[AW]-iCims

We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right. Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery.

Superior quality and care. Compassion and Respect. Results oriented. Teamwork. Resourcefulness. These are the core values upon which Select Medical was built. Since its founding in 1996, Select Medical has passionately focused on providing superior, patient-centered care that improves quality of life.Co-founded by Rocco Ortenzio and Robert Ortenzio, Select Medical began as a regional provider of outpatient physical rehabilitation. Contract therapy was added to the company's specialized health care offerings in 1997, and was quickly followed by the introduction of long-term acute care in 1998. In 1999, Select Medical made one of its largest acquisitions by purchasing NovaCare Physical Rehabilitation and Occupational Health. In three years, Select Medical had grown from a small start-up into a diversified health care company with a national presence. This progressive yet responsible growth was one attribute that led to the company's recognition as one of the Best Managed Companies in America by Forbes magazine.

Select Medical Corp

HOUR

Select Specialty Hospital - Battle Creek

Works collaboratively with the social worker and other disciplines to ensure a safe, appropriate, and timely transition to the next level of care, taking into consideration the patient's available resources. Basic Life Support (BLS) certification as a Healthcare Provider by the American Heart Association, American Red Cross or equivalent through the Military Training network (MTN).

Registered Nurse Care Manager

Certification: Case Management is desirable: Individuals serving as case managers for the health system shall obtain CMSA certification within three years from their date of employment in the role or be in the process of obtaining certification as a case manager. The ED Case Manager coordinates actions within the emergency center admission process that provide for patient's receiving the right care at the right time, in the right place.

Registered Nurse RN - Case Manager - Emergency

At DMC Harper University/Hutzel Women's Hospital , we’reseeking an innovative and experienced healthcare leader to drive excellence and inspire our teamtowards exceptional patient outcomes andoperational success. A specialty referralhospital, Harper has established Centers of Excellence in neurosciences, bariatricsurgery, vascular services, multidisciplinary cardiovascular services, hypertension,stroke prevention and heart failure.

DMC Harper University/Hutzel Women's Hospital

Case Management Manager

This role is responsible for performing prospective, concurrent, and retrospective medical reviews to determine medical necessity, appropriate level of care, intensity of service, and length of stay for healthcare services. The ideal candidate will have a strong clinical background, experience evaluating patient care needs, and the ability to collaborate with providers, facilities, and members to support quality healthcare outcomes.

Epitec is a leading staffing and recruiting services company with a mission to make staffing personal. We go beyond traditional hiring by truly understanding our candidates and matching them with the perfect opportunities. We offer competitive compensation, career growth, and support throughout the entire process. Working with top Fortune 500 companies, we are recognized for our excellence with numerous awards, including Best & Brightest and diversity recognitions. At Epitec, we're redefining the future of employment.

Epitec Inc

Registered Nurse-Review Analys

Other: Collaborates closely with, providing oversight as needed to, the Clinical Manager/Charge RN acting as nurse manager, the Medical Director, and the physicians regarding the direct patient care responsibilities within the facility to ensure the provision of outstanding quality of patient care, as defined by the FMS quality goals, and compliance with the pertinent company policies and procedures. Demonstrated leadership competencies and management skills for the position, including excellent communication, customer service, continuous quality improvement, relationship development, results orientation, team building, motivating employees, performance management and decision making.

Fresenius Medical Care AG & Co KGaA

Dialysis Clinical Manager Registered Nurse - RN

DMC Huron Valley-Sinai Hospital

Goals of Care: Facilitates Advanced Directives, Facilitates Goals of Care and End-of Life Discussions with participants and families: Facilitates Advanced Directives, Manages end-of-life with support of consulting hospice service. In accordance to Michigan law, an NP may practice independently within his/her scope of practice per professional license; specifically, a Nurse Practitioner may practice independent per RN licensing scope.

Mission 
 

PACE Southeast Michigan - (Program of All-Inclusive Care for the Elderly) is a unique health plan and care provider, committed to keeping seniors with challenging healthcare conditions in their home, by caring for their medical, physical and social needs.

 
 
Values

Extraordinary Care 
Collaborative Teamwork 
Inspired Achievement 
Accountability 
Adaptive Growth

Utilization Management Nurse Jobs in Michigan

Director Case Management [Full Time / Permanent] Central Business Solutions

Director - Case Management DMC Receiving Hospital

Director Case Management Veracity Ventures Inc.

NP / PA - Acute Pain Trinity Health

Registered Nurse (Psych Nurse) Insight

Integrated Care Management Administrative Assistant McLaren Health Care Corp

RN Care Coordinator Corewell Health

RN Care Coordinator Rehab inpatient Corewell Health

Social Worker - Case Management DMC Sinai-Grace Hospital

Clinical Social Worker Case Management Tenet Healthcare Corp

Case Manager / PRN ( RN / RT / SW / LPN ) Select Specialty Hospital - Ann Arbor

Case Manager / PRN ( RN / RT / SW / LPN ) Select Medical Corp

Case Manager / PRN ( RN / RT / SW / LPN ) Select Specialty Hospital - Battle Creek

Registered Nurse Care Manager McLaren Health Care Corp

Registered Nurse RN - Case Manager - Emergency Trinity Health

Case Management Manager DMC Harper University/Hutzel Women's Hospital

Registered Nurse-Review Analys Epitec Inc

Dialysis Clinical Manager Registered Nurse - RN Fresenius Medical Care AG & Co KGaA

Social Worker - Case Management DMC Huron Valley-Sinai Hospital

Nurse Practitioner - Part Time - Westland PACE Southeast Michigan

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