Medical Documentation Specialist - Onsite/Hybrid position GEMCOREMedical Documentation Specialist - Onsite/Hybrid positionLivonia, MIRemoteThe Diabetes Documentation's primary role is to obtain documentation directly from physician offices for the purpose of qualifying a customer for prescribed supplies and maintaining compliance with Medicare, Medicaid, and commercial insurances. Edwards Health Care Services (EHCS), a division of GEMCORE , is a well-established and growing national direct-to home medical supply provider.
Medical Documentation Specialist - Onsite/Hybrid position Edwards Health Care ServicesMedical Documentation Specialist - Onsite/Hybrid positionLivonia, MichiganRemoteGEMCORE, a family of companies headquartered in Hudson, Ohio - Edwards Health Care Services, GEMCO Medical, GemCare Wellness, and GEM Edwards Pharmacy - offers a core set of healthcare solutions by partnering with manufacturers, providers, employer groups, insurance groups, and patients to deliver high quality healthcare products and innovative services to proactively better lives. The Diabetes Documentation's primary role is to obtain documentation directly from physician offices for the purpose of qualifying a customer for prescribed supplies and maintaining compliance with Medicare, Medicaid, and commercial insurances.
Non-Fault - Paralegal Specialist - Metro Detroit, MI - (Hybrid) Allstate Insurance CompanyNon-Fault - Paralegal Specialist - Metro Detroit, MI - (Hybrid)MIRemote$28.03–$42.99 / hourArbitration, Attorney Support, Case Law, Case Management, Case Preparation, Civil Litigation, Court Filings, Insurance Defense, Legal Analysis, Legal Consulting, Legal Discovery, Legal Software, Legal Strategies, Legal Writing, Litigation. With access to hands-on training and mentorship from a collaborative team of paralegals and attorneys, you'll build deep expertise and grow your career in a supportive, fast-paced legal environment.
Director, Healthcare Services - REMOTE Molina Healthcare IncDirector, Healthcare Services - REMOTEWarren, 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.
Remote/Hybrid Hourly Dietitian Compass Group North AmericaRemote/Hybrid Hourly DietitianDetroit, MIRemote$35–$40 / hourCompass Group employs over 3,000 RDNs across the United States, making us one of the nation's largest employers of Dietitians in a variety of settings: Hospitals and healthcare systems. The company has earned significant recognition, including being named one of Modern Healthcare's "Top 100 Best Places to Work in Healthcare" for five consecutive years, and appearing on Training Magazine's Top 125 Organizations list for six straight years.
Remote/Hybrid Hourly Dietitian Compass Group USA IncRemote/Hybrid Hourly DietitianDetroit, MIRemote$35–$40 / hourCompass Group employs over 3,000 RDNs across the United States, making us one of the nation's largest employers of Dietitians in a variety of settings: Hospitals and healthcare systems. The company has earned significant recognition, including being named one of Modern Healthcare's "Top 100 Best Places to Work in Healthcare" for five consecutive years, and appearing on Training Magazine's Top 125 Organizations list for six straight years.
Bilingual RN Field Care Manager (Arabic or Chaldean) HCBS/LTSS Humana IncBilingual RN Field Care Manager (Arabic or Chaldean) HCBS/LTSSMIRemote$71,100–$97,800 / yearConducts comprehensive InterRAI Integrated Health Care (IHC) assessments and Nursing Facility Level of Care Determinations (NFLOCDs) to evaluate members' clinical, functional, cognitive, behavioral, and psychosocial needs; support accurate eligibility decisions and person-centered care planning; and ensure compliance with state Medicaid, LTSS, HCBS waiver, and regulatory requirements. Work 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.
RN 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.
RN Field Care Manager - Medicaid HCBS/LTSS Humana IncRN Field Care Manager - Medicaid HCBS/LTSSMIRemote$71,100–$97,800 / yearConducts comprehensive InterRAI Integrated Health Care (IHC) assessments and Nursing Facility Level of Care Determinations (NFLOCDs) to evaluate members' clinical, functional, cognitive, behavioral, and psychosocial needs; support accurate eligibility decisions and person-centered care planning; and ensure compliance with state Medicaid, LTSS, HCBS waiver, and regulatory requirements. Work 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.
RN Field Care Management Team Lead (HCBS & LTSS) Wayne & Macomb Counties Humana IncRN Field Care Management Team Lead (HCBS & LTSS) Wayne & Macomb CountiesMIRemote$71,100–$97,800 / yearWork 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. Collaborate with nonclinical associates to facilitate research, conduct nonclinical assessments, address scheduling needs, and ensure comprehensive support for all Interdisciplinary Care Team (ICT) participants, including effective meeting coordination and communication updates.
RN Review Analyst KYYBA, IncRN Review AnalystDetroit, MIRemoteFounded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances. Responsibilities include providing clinical and educational support assessments, analysis, coordination of the quality and training management program, assisting in the divisional accreditation process, and conducting/assisting with internal and external audits.
NewRemote Call Center Triage Registered Nurse CVS Health CorpRemote Call Center Triage Registered NurseMIRemote$26.01–$74.78 / hourThe progression path from Level I to Level II positions within the Triage RN team is a structured path that encourages nurses to widen their knowledge base, take on more responsibility, demonstrate expertise, and reward team members for their proven success and dedication. Role Description: The Clinical Call Center Triage Nurse effectively extends care during and outside of regular Oak Street Health clinic hours by addressing patients' medical, social, and psychological needs telephonically.
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.
MICHIGAN Registered Nurse REMOTE - Patient Assessment J & B Medical Supply Co IncMICHIGAN Registered Nurse REMOTE - Patient AssessmentMIRemoteConsults by phone with client, primary caregiver, primary care physician or specialist, case managers and other community resources to determine if client qualifies for a particular program. Summary: Our Staff Nurse's are responsible for conducting patient assessments by phone (ours) to determine individual needs for incontinence supplies.
NewRN Case Manager- Chronic Care Management Belle, LLCRN Case Manager- Chronic Care ManagementDetroit, MIRemote$70,000–$80,000 / yearThis role is ideal for a compassionate nurse who is experienced in care coordination and chronic disease management, and passionate about improving the health and well-being of members through personalized, holistic support. Leverage strong people skills to relate to members, show empathy for their situational/clinical circumstances, and seek creative ways to advocate for the member's best interest.
NewQuality Compliance Professional Humana IncQuality Compliance ProfessionalMIRemote$71,100–$97,800 / yearWork 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. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it.
NewDirector of Sales & Business Development Harris Computer SystemsDirector of Sales & Business DevelopmentMIRemote$80,000–$110,000 / yearYou'll work alongside experienced professionals, including a professional services team comprised of Registered Nurses and former perioperative staff, who bring deep clinical expertise and a customer-centric perspective to every challenge. About Picis: Join Picis, a global leader in perioperative and critical-care information systems, where you'll be part of a team that is genuinely pleased with their colleagues and thrives in a positive, comfortably fast-paced environment.
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.
RN Utilization Management Optech, LLCRN Utilization ManagementDetroit, MIRemoteJob 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. Analyze, research, respond to and prepare documentation related to retrospective review requests and appeals in accordance with local, state and federal regulatory and designated accreditation (e.g.