NewCase Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County) CVS HealthCase Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)Detroit, MIRemote$60,522–$129,615The LTSS RN Case Manager is responsible for comprehensive assessment, care planning, coordination, implementation, and monitoring of Long-Term Services and Supports (LTSS) for dual-eligible Medicare and Medicaid members. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs.
Employee Experience (EX) Advisor - Healthcare Press Ganey Associates LLCEmployee Experience (EX) Advisor - HealthcareMIRemote$81,000–$115,000 / yearHowever, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. Press Ganey is the leading experience measurement, data analytics, and insights provider for complex industries-a status we earned over decades of deep partnership with clients to help them understand and meet the needs of their key stakeholders.
Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEAnn Arbor, MIRemoteRegistered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), Licensed Professional Clinical Counselor (LPCC), or Licensed Master of Social Work (LMSW). At least 8 years of health care experience, and at least 5 years of managed care experienced in one or more of the following areas: utilization management, care management, care transitions, behavioral health, long-term services and supports (LTSS), or equivalent combination of relevant education and experience.
NewRN Field Care Manager Nurse HumanaRN Field Care Manager NurseDetroit, MichiganRemoteWork at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. The Field Care Manager Nurse 2 assesses and evaluates member's needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members.
Case Manager Registered Nurse - Field MI (Wayne and Macomb County) CVS Health CorpCase Manager Registered Nurse - Field MI (Wayne and Macomb County)Dearborn, MIRemote$60,522–$129,615 / yearWith compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members health care and social determinant needs. Collaborates with supervisor and other key stakeholders in the members healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
Nurse Auditor, Revenue Integrity - (Remote) Trinity HealthNurse Auditor, Revenue Integrity - (Remote)Livonia, MIRemote$31.88–$47.82 / hourNS IV - licensed: Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs / counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or lead / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified healthcare professionals within licensed scope of practice. Work Focus: Performs clinical care activities (direct or indirect) for patients within the "scope of practice" laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management) 3:15Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)Detroit, MIRemoteAssist patients in the navigation of their healthcare (example - assisting patients with scheduling appointments, coordinating with specialists, and ensuring preventative screenings are completed, etc.). We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management.
Case Manager RN Optech, LLCCase Manager RNMIRemoteThey serve as the single point of contact for members, caregivers, and providers using a variety of communication channels including phone calls, emails, text messages and the BCBSM online messaging platform. Job Description: The Case Manager RN leads the coordination of a multidisciplinary team to deliver a holistic, person centric care management program to a diverse health plan population with a variety of health and social needs.
RN Health Care Facility Surveyor Impact Recruiting SolutionsRN Health Care Facility SurveyorDetroit, MichiganRemote$75,000–$90,000The Surveyor will serve as a team member or team leader on various types of surveys (i.e. re-certification, comparative, complaint investigation, and revisits) for long-term care and non-long-term care surveys, which can include; ambulatory surgical centers (ASC), Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID), end-stage renal disease (ESRD), Psychiatric Residential Treatment Facility (PRTF), hospital, critical access hospital, and hospice facilities. Impact Recruiting Solutions is currently seeking a RN Health Care Facility Surveyor to fill an opening with a Quality Improvement Consulting Company and will work in a technically exciting environment supporting internal and external customers nationwide .
NewRemote Revenue Integrity Nurse Auditor Trinity HealthRemote Revenue Integrity Nurse AuditorLivonia, MichiganRemoteNS IV – licensed : Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs / counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or lead / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified healthcare professionals within licensed scope of practice. Work Focus: Performs clinical care activities (direct or indirect) for patients within the “scope of practice” laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
Transition of Care Coach (RN) Remote (Must Reside in Michigan) Molina Healthcare IncTransition of Care Coach (RN) Remote (Must Reside in Michigan)Detroit, MIRemoteEducates and supports member focusing on seven primary areas (Transition of Care Pillars): medication management, use of personal health record, follow-up care, signs and symptoms of worsening condition, nutrition, functional needs and or home and community-based services, and advance directives. Follows member throughout a 30 day program that starts at hospital admission and continues oversight through transitions from acute setting to all other settings, including nursing facility placement/private home, with the goal of reduced readmissions.
Care Manager, LTSS (RN) Molina Healthcare IncCare Manager, LTSS (RN)Detroit, MIRemoteAt least 2 years of experience in health care, including at least 1 year experience in care management, managed care, and/or experience in a medical or behavioral health setting, and at least 1 year of experience working with persons with disabilities, chronic conditions, substance abuse disorders, and long-term services and supports (LTSS), or equivalent combination of relevant education and experience. Develops and implements care plans, including a waiver service plan in collaboration with members, caregivers, physicians and/or other appropriate health care professionals and member support network to address the member needs and goals.
Care Manager (RN) Remote (Detroit, MI) Molina Healthcare IncCare Manager (RN) Remote (Detroit, MI)Detroit, MIRemoteCompletes comprehensive assessments of members per regulated timelines and determines who may qualify for care management based on clinical judgment, changes in member health or psychosocial wellness and triggers identified in assessments. Develops and implements care coordination plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
Nurse Auditor, Revenue Integrity - (Remote) Trinity Health CorporationNurse Auditor, Revenue Integrity - (Remote)Livonia, MIRemote$32.52–$48.78 / hourNS IV - licensed: Licensed role (direct or indirect healthcare); Provides nursing interventions or clinical knowledge application in decision-making; Participates in the planning, implementation & / or evaluation of & solutions for care; Performs delegated focused / holistic care autonomously according to care plan; May administer medication & carry out the therapeutic treatment within scope of license (state & TH policy); Performs direct & essential care or supportive activities as part of an interdisciplinary team with a deeper understanding, including theoretical knowledge; Demonstrates a level of independence to perform activities with general oversight, through personal contributions, teamwork & initiatives to safely improve outcomes; Advocates for patients & informs / counsels patients & families about illness & care details; May serve as a knowledge resource, role model & mentor or lead / coordinate / supervise direct & essential care activities or role-based service responsibilities of unlicensed / licensed / certified healthcare professionals within licensed scope of practice. Work Focus: Performs clinical care activities (direct or indirect) for patients within the "scope of practice" laws & training received; Cares for patients safely by assisting in clinical care services or engaging in administrative activities (e.g., maintaining records or supplies) that enhance or improve coordination, preparation & flow of the care experience.
Clinical Documentation Specialist Audit Coordinator (Remote) Trinity HealthClinical Documentation Specialist Audit Coordinator (Remote)Livonia, MIRemote$41.43–$62.15 / hourDemonstrates understanding of and facilitates appropriate clinical documentation, to ensure that the medical necessity, severity of illness, risk of mortality, accurate coding, clinical evidence, resources consumed, and level of services provided are accurately reflected in the health record. Responsible for reviewing and/or auditing medical record clinical documentation to support the medical necessity, severity of illness, risk of mortality, accurate coding, clinical evidence, resources consumed, and level of services rendered to all patients.
Remote Nurse Care Manager - NY, NV, MI, MN, ID, IL, HI, DC, CA, AK PharmD Live CorpRemote Nurse Care Manager - NY, NV, MI, MN, ID, IL, HI, DC, CA, AKMIRemoteDeliver personalized care management and coordination services Conduct patient assessments and develop individualized care plans Support chronic disease management (e.g., diabetes, hypertension, CHF, COPD) Provide education on disease states, medications, and self-management strategies Utilize motivational interviewing techniques to enhance adherence and engagement Collaborate with providers and care teams to align treatment plans Identify care gaps, risks, and barriers to optimal outcomes Maintain accurate, compliant, and timely documentation Support care transitions and follow-up coordination. Strong clinical judgment and attention to detail Excellent communication and interpersonal skills Ability to build rapport and trust in a remote setting Patient-centered, outcomes-driven mindset Self-motivated and able to work independently High level of professionalism and accountability.
Fp&A Systems Analyst AHS StaffingFp&A Systems AnalystWarren, MIRemote$90,000–$105,000 / yearThis is a highly cross-functional role that partners closely with FP&A, Accounting, and Technology teams to build and maintain the infrastructure that supports financial planning and analysis. That success is powered by a highly engaged team of talented individuals working toward one shared purpose: improving access to quality care in order to positively impact patient outcomes.