NewCase Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County) CVS HealthCase Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)Clinton Township, 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.
Medical Documentation Specialist - In office/Hybrid position GEMCOREMedical Documentation Specialist - In office/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. Magazine’s list of America’s Fastest-Growing Companies and with the Cleveland Plain Dealer as a Top Workplace seven years running!
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.
Medical Documentation Specialist - In office/Hybrid position Edwards Health Care ServicesMedical Documentation Specialist - In office/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.
NewRN Field Care Manager Nurse HumanaRN Field Care Manager NurseDetroit, MichiganRemoteWork-at-Home (WAH) Internet Statement: 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. 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.
NewRegistered Nurse Trinity HealthRegistered NurseAnn Arbor, MIRemotePhysical activity that sometimes requires handling and lifting patients, transferring patients to gurney using slide board, assisting patients with dressing/undressing, transferring patients to wheelchair using gaitbelt, walking, bending, stooping, reaching, climbing, kneeling and/or twisting. Responsible for efficiently triaging patient needs via telephone and during visits to ensure appropriate timely access to the appropriate level of care, reducing avoidable emergency department visits and readmissions according to IHA's Policies and Protocols.
Case Manager Registered Nurse - Field MI (Wayne and Macomb County) CVS Health CorpCase Manager Registered Nurse - Field MI (Wayne and Macomb County)Sterling Heights, 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.
NewNurse Auditor Humana IncNurse AuditorMIRemote$78,400–$107,800 / 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. 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.
NewUtilization Management Behavioral Health Professional Humana IncUtilization Management Behavioral Health ProfessionalMIRemote$65,000–$88,600 / 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. The Utilization Management Behavioral Health Professional uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members.
NewNurse Auditor, Revenue Integrity -(Remote) Trinity HealthNurse Auditor, Revenue Integrity -(Remote)Livonia, 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.
NewNurse Auditor, Revenue Integrity - (Remote) Trinity HealthNurse Auditor, Revenue Integrity - (Remote)Livonia, 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.
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.
NewRN 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 .
Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management) 3:15Remote Registered Nurse (Remote Patient Monitoring & Chronic Care Management)Detroit, MIRemote$55,000–$65,000Assist 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.
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.
NewCare 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.
RN Health Care Facility Surveyor Greenlife Healthcare StaffingRN Health Care Facility SurveyorMacomb, MIRemote$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.
NewClinical Documentation Specialist - Full Time - CDI HIM (Remote) Trinity HealthClinical Documentation Specialist - Full Time - CDI HIM (Remote)Pontiac, MichiganRemoteMust possess one of the following: Current Registered Nurse License in the State of practice, Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) required, Licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion of medical school. Two (2) years’ experience in Critical Care, Medical or Surgical Inpatient Care Nursing, as an RN, physician assistant (PA), nurse practitioner/advanced practice nurse (NP/APN), medical school graduate or as an inpatient coder preferred.
Resource RN - Pop Health - Up to 90% remote - Must have an active IL license. Cityblock Health IncResource RN - Pop Health - Up to 90% remote - Must have an active IL license.MIRemote$71,000–$90,500 / yearMeet members in various community settings such as homes,shelters, or hospitals, serving as an extender of care team providers and performing tasks like administering injections, monitoring vital signs, and in-home medication reconciliation. Medical Clearance (for Member-Facing Roles): You must complete Cityblock's medical clearance requirements, which include, but may not be limited to, evidence of immunity to MMR, Hepatitis B, Varicella, and a TB screen, or have an approved medical or religious accommodation that precludes you from being vaccinated against these diseases.
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.