Utilization review nurse jobs in Dearborn, MI - 89 jobs

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the RN Utilization Review Nurse position for you! Company Job Description/Day to Day Duties: Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines Provider appeals and Utilization reviews and assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team. Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures. Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long Term Care. Hours for this Position: Mon-Fri: 8:30am - 5pm Advantages of this Opportunity: Great salary between $33 - 37! Great benefits!!! Fun and positive work environment! Qualifications Minimum Education/Qualifications/Licensures: Must be an RN Utilization Review background in either Managed Care of Provider environment (at least one year) Interqual experience (at least one year) Also has a background in patient, skilled nurses facilities, rehab, and home healthcare. Other basic computer skills necessary: Microsoft Office, Data Entry, etc. Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management. Great typing and data entry skills Additional Information Interested in being considered? If you are interested in being considered for this position, please click the apply button below. Or call John Wood 407-478-0332 ext 225

Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape-analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective DUR and prepare stakeholder reports. Qualifications: PharmD with managed care, DUR, or pharmacy benefit experience. Strong Excel/data analytics background preferred. Understanding of clinical guidelines and P&T processes. Why Join Us? Join a top-tier managed care team Hybrid flexibility Strategic and data-driven focus

Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************

Job Description Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations. The building B.L.O.C.K.S. of our team's success! Bring the fun Leverage together for better Outperform yourself Care at every touchpoint Keep your word. Keep it real Stay curious & listen well Primary Purpose: We are proud of the quality care we provide members, and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at-risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities. Learn more about our primary purpose here Follow us on LinkedIn: ****************************************** NP Responsibilities: In-home Clinical Assessments Travel to members' homes and conduct comprehensive health evaluations Conduct Annual Wellness Visits and health assessments for members with chronic conditions. Perform: Medical history and physical examinations Review of systems Vital signs collection Medication review and reconciliation Possible preventive health screenings Hemoglobin A1C Spirometry KED (Kidney Health Evaluation) DRE (Diabetic Retinal Exam) FIT Patient Education & Engagement Deliver preventive health education and counseling opportunities. Educate patients on ongoing health monitoring, medication adherence, and chronic condition management. Support informed decision-making and ensure true, informed consent. Engage in goals of care discussions when appropriate. Care Coordination & Quality Support Identify clinically relevant diagnoses for care management and risk adjustment documentation. Communicate findings used to generate post visit summaries for the primary care provider. Identify and help close quality care gaps (e.g., screenings, labs, follow-ups). Collaborate enthusiastically with the broader care team to enhance clinical quality and patient experience. Compliance & Professional Standards Adhere to HIPAA regulations and safeguard protected health information (PHI). Maintain accurate, timely, and compliant EMR documentation. Perform additional duties as assigned in alignment with organizational goals. An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Washtenaw County, Michigan Requirements Travel Requirements Daily travel expectations remain within a 55-mile radius of the assigned home location. NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in This role requires travel up to a maximum 55-mile radius originating in the assigned job posting county Preference is given to weekday schedules Preference is given to standard working hour schedules Previous in-home risk assessment experience preferred Previous 1099 (PRN) experience is preferred but not required 3 years patient care experience preferred (primary care/adult/geriatric, EMR) May be requested to obtain additional NP licensure supported by Advantmed Access to reliable transportation that will enable you to travel to members' homes within a designated area Strong ability to work within our EMR system Ability to work independently Bilingual is a plus Benefits Advantmed offers: Competitive compensation of ~$100 per completed in-home health assessment Paid mileage Flexible work schedule, choose your own schedule No on call Visits ready to be scheduled immediately Appointment confirmation support Dedicated coordinator support Advanced member scheduling coverage State of art technology

Travel within Wayne and Macomb county. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. **Duties:** Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or members needs to ensure appropriate administration of benefits Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures **Experience:** · Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required. · Healthcare and/or managed care industry experience. · Case Management experience preferred-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding · Effective communication skills, both verbal and written. · Ability to multitask, prioritize and effectively adapt to a fast paced changing environment · Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer. · Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. · Typical office working environment with productivity and quality expectations **Education:** · RN with current unrestricted state licensure. · Case Management Certification · CCM preferred **Skills:** **About US Tech Solutions:** US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit *********************** . US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Physician Assistant or NP credentialed and certified to work in Michigan, with Diabetic experience and insulin pumps for an endocrinology office. Qualifications Experience is a plus

Responsible for the coordination of the Resident Assessment Instrument (RAI), the electronic transmission of RAI data to the state Bulletin Board in accordance with State and Federal regulations and facility policies. Facilitates communication between the Interdisciplinary Team. Ongoing education of those preparing the M.D.S. Essential Duties & Responsibilities RAI Preparation and Process Schedules completion of RAI following State and Federal guidelines. Notifies Interdisciplinary Team members with distribution of schedules showing dates of assessment schedules. Assists in completion of RAI as needed. Assists with data input into the RAI computer system. Supervises the completion of the RAI by the Interdisciplinary Team. Modification to assessment schedule to ensure appropriate RUG score for each individual resident. Screens each Minimum Data Set (MDS) for accuracy before finalizing, locking, and signing. Transmits RAI data to the state weekly or as needed. I. Tracks Validation Reports, Monthly and Quarterly Reports from the state. II. Medicare Review and Coverage Active interaction with the Interdisciplinary Team in daily conference to evaluate each resident's status and needs relative to Medicare skilled coverage and potential for RUG category changes. Assist Interdisciplinary staff with Medicare review via chart audit in order to ensure that: Change of condition RAIs are initiated when appropriate; Review chart documentation, including nursing and ancillary progress notes, care plans, and CNA notes, reflects the need for the care and services the resident receives; 3. Medicare coverage is discontinued when resident no longer meets criteria. III. Other Duties Develop customized tracking tools and/or forms for interdisciplinary team members (i.e. D.O.N., A.D.O.N., Nurse managers, Social Services) Ensures RAI/MDS software is functioning properly and is in contact with software vendor to ensure that facility is using the most current version of software. Clarification of Medicare Certification/Re-Certification forms for different disciplines. Assist with the completion and maintenance of the Resident Roster and the Census and Condition Reports. Works closely with the state RAI/MDS automation coordinator. Coordinates with the billing department on assessment schedules for effective date of assessments and clarification of billing assessment codes to complete the billing cycle in a timely manner. Utilizes the Internet for research and information gathering for changes in the RAI and Medicare process. Acts as a liaison to the Interdisciplinary Team. H. Performs other duties incidental to the position and as delegated by the Director of Nursing.

Certified Student Support Services/School Nurse District: Oak Park Schools Attachment(s): District Nurse.pdf

Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Corrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities. Overview Help Accepting applications Open & closing dates 10/01/2025 to 09/30/2026 Salary $50,241 to - $114,573 per year Pay scale & grade GL 05 - 10 Locations Many vacancies in the following locations: Aliceville, AL Maxwell AFB, AL Talladega, AL Forrest City, AR Show morefewer locations (90) Phoenix, AZ Safford, AZ Tucson, AZ Atwater, CA Herlong Sierra Ordnance Depot, CA Lompoc, CA Los Angeles, CA Mendota, CA San Diego, CA Victorville, CA Florence, CO Littleton, CO Danbury, CT Coleman, FL Marianna, FL Miami, FL Miami-Dade County, FL Tallahassee, FL Atlanta, GA Jesup, GA Honolulu, HI Chicago, IL Greenville, IL Marion, IL Pekin, IL Thomson, IL Terre Haute, IN Leavenworth, KS Ashland, KY Inez, KY Lexington, KY Manchester, KY Pine Knot, KY Oakdale, LA Pollock, LA Fort Devens, MA Cumberland, MD Milan, MI Duluth, MN Rochester, MN Sandstone, MN Waseca, MN Springfield, MO Yazoo City, MS Butner Federal Correctional Complex, NC Berlin, NH Fairton, NJ Fort Dix, NJ Kings, NY Otisville, NY Ray Brook, NY Elkton, OH El Reno, OK Oklahoma City, OK Sheridan, OR Gregg Township, PA Kelly Township, PA Lewis Run, PA Loretto, PA Minersville, PA Philadelphia, PA Waymart, PA Guaynabo, PR Bennettsville, SC Edgefield, SC Estill, SC Salters, SC Yankton, SD Memphis, TN Bastrop, TX Beaumont, TX Big Spring, TX Bryan, TX Federal Medical Center Carswell, TX Fort Worth, TX Houston, TX La Tuna, TX Seagoville, TX Texarkana, TX Three Rivers, TX Jonesville, VA Prince George, VA Seatac, WA Grand Marsh, WI Alderson, WV Beaver, WV Bruceton Mills, WV Glenville, WV Morgantown, WV Welch, WV Remote job No Telework eligible No Travel Required Occasional travel - Travel may be required for training and/or work related issues. Relocation expenses reimbursed No Appointment type Permanent Work schedule Full-time - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Service Competitive Promotion potential 10 - Grade 10 - Registered Nurse Accelerated Promotion Program covers the 0610 series ranging from GL-05 through GL-10 grade levels. If eligible, this enables a Registered Nurse to promote up to twice at an accelerated pace through a training program. Job family (Series) * 0610 Nurse Supervisory status No Security clearance Other Drug test Yes Bargaining unit status No Announcement number DHA-2026-0002 Control number 847130700 This job is open to Help The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Career transition (CTAP, ICTAP, RPL) Federal employees whose job, agency or department was eliminated and are eligible for priority over other applicants. Clarification from the agency This is a public notice under the Direct Hiring Authority open to all U.S. citizens. Please review instructions in the "

Job Description Job Title: Registered Nurse Employment Type: Full-time Please Note: You will never be charged a fee at any stage of this process. Job Bridge Global does not charge recruitment or registration fees. All costs are covered by the employer. This role is based in the United States. Requirements Position Overview We are seeking dedicated and compassionate Registered Nurses to join a large hospital in Michigan and Indiana. This is an exciting opportunity to make a real impact on patient lives, working within a supportive and professional environment. All visa and registration costs are covered, plus a signing on bonus, relocation assistance, health benefits, and opportunities to advance your nursing career all with a promise of a good work to life balance. As a Registered Nurse, you will deliver high-quality, patient-centered care while collaborating with interdisciplinary medical teams to ensure the well-being and recovery of your patients. Key Responsibilities Direct Patient Care: Deliver safe, effective, and empathetic care in accordance with established clinical standards. Clinical Assessments: Monitor patient conditions, perform assessments, administer medications, and track vital signs. Care Planning: Develop and implement individualized care plans in coordination with physicians and other healthcare professionals. Team Collaboration: Work closely with doctors, specialists, and therapists to ensure comprehensive patient care. Patient Communication: Educate and support patients and their families on treatment plans and health management. Documentation: Maintain accurate and up-to-date medical records in line with facility and regulatory requirements. Compliance: Follow all relevant healthcare laws, regulations, and facility policies to maintain high safety and ethical standards. Candidate Requirements Education: Bachelor's Degree in Nursing (BSN). Experience: A minimum of 1-2 years of experience is preferred. Newly qualified nurses are also encouraged to apply. Skills: Strong clinical knowledge, attention to detail, effective communication skills, and the ability to thrive under pressure. Attributes: Compassionate, empathetic, and committed to high standards of patient care. Language: Proficiency in English (reading, writing, speaking, and listening) is essential. Benefits What's on Offer Competitive pay: Starting at $37 per hour but could be higher depending on experience Visa sponsorship and full relocation support Career growth opportunities Professional training and ongoing development Supportive and inclusive work environment Health, dental, and vision insurance Generous paid time off (PTO) Retirement plans with employer contributions Tuition reimbursement & ongoing education opportunities Opportunities for advancement in a growing health system How to Apply Submit your application through our online form. A member of our team will be in touch to guide you through the next steps.

Job Description With two decades of excellence, Kalologie Medspa stands as a premier destination for aesthetic and wellness treatments. Our team of highly trained experts is renowned for their personalized approach, providing safe, effective, and medically-proven treatments that achieve exceptional results. We are proud of our team based culture, with a genuine focus on well-being. As we continue to expand, we remain committed to our core values and a passionate pursuit of excellence. Position Overview: We are seeking experienced Registered Nurses(RN) to perform IV Infusion Therapy at our location inside Club Studio in Troy. You thrive working in a fast-paced environment and are always willing to learn more and strengthen your skills to deliver the best service and results. The ideal candidate would have specialized training in infusion therapy. Key Responsibilities: Prepare and set up the IV infusion. Foster a calming atmosphere and closely monitor the IV administration process. Conduct client consultations to create customized treatment plans and deliver services that meet individual needs and goals. Educate clients on treatment processes, including detailed pre- and post-care instructions. Address client inquiries, respond to their needs, and manage expectations effectively. Ensure client safety and satisfaction throughout all treatments. Promote and suggest relevant retail products and additional services offered by the company. Maintain and sanitize equipment and manage inventory of products. Adhere to established treatment protocols. Keep detailed records, including client charts. Build and maintain a strong client base. Participate in training sessions and meetings as needed. Perform other assigned duties as required. Occasionally travel to other locations for training purposes. Qualifications: Active license as a Registered Nurse (RN), Nurse Practitioner (NP), Physician Assistant (PA) in the state of employment. Minimum of 2 years of relevant experience preferred. Experience in a clinical setting is a plus. Exceptional interpersonal and communication skills, with the ability to effectively interact with clients, colleagues, and managers. Ability to multitask, stay attentive to client needs, and adapt to business requirements. Strong team player with the ability to take initiative and work independently. Availability to work evenings and weekends is required. Kalologie offers a competitive salary with flexible schedules, generous service discounts, and ongoing training opportunities on new techniques, equipment and products. We promote continued growth and development through our rapidly expanding medical aesthetic clinics.

Become a Key Player: MDS Nurse at Pomeroy Living! Are you a meticulous and compassionate RN with a knack for detail and a passion for ensuring quality care? Pomeroy Living is looking for a dedicated and experienced MDS (Minimum Data Set) Nurse to join our exceptional team! In this vital role, you will be the cornerstone of our resident assessment process, coordinating and completing accurate and timely MDS assessments that directly impact individualized care plans and regulatory compliance. If you thrive in a collaborative environment and are committed to excellence in patient care, we invite you to apply! Your Core Responsibilities Include: MDS Assessment Mastery: Expertly coordinate and complete all MDS assessments with precision and punctuality, ensuring full compliance with state and federal regulations. Interdisciplinary Collaboration: Work seamlessly with our diverse interdisciplinary team (nurses, therapists, social workers, etc.) to develop comprehensive and truly individualized care plans that meet each resident's unique needs. Resident & Family Communication: Clearly and compassionately communicate assessment results and care plan details to residents and their families, fostering transparency and involvement in their care journey. Quality Improvement Champion: Actively participate in ongoing quality improvement initiatives, contributing your expertise to enhance our MDS assessment processes and overall resident outcomes. What You Bring (Qualifications): A Current RN or LPN license in the state of Michigan is required. A minimum of two (2) years of proven experience in MDS coordination within a skilled nursing or similar healthcare setting. A strong, in-depth understanding of the entire MDS assessment process and all related state and federal regulations. Exceptional communication and interpersonal skills, allowing you to effectively collaborate and build rapport. A demonstrated ability to work effectively and contribute positively in a dynamic team environment. Excellent problem-solving and decision-making skills, with an eye for detail and accuracy. Your Rewarding Benefits at Pomeroy Living: Paid Time Off: Start accruing from your very first day of orientation! Paid Holidays: Enjoy time off to celebrate. Financial Flexibility: Access up to 50% of your earned pay DAILY! Flexible Scheduling: We support a work-life balance. Company-Paid Life Insurance: For all full-time staff. Comprehensive Health Coverage: Priority Health Medical, Delta Dental, and Vision Insurance. 401(k) Retirement Plan: Invest in your future. Career Advancement Opportunities: Grow your career within the Pomeroy Living family. If you are a dedicated RN or LPN with strong MDS expertise and a commitment to resident-centered care, we encourage you to apply and make a significant difference at Pomeroy Living!

Job DescriptionAbout us: Rushton Recovery provides Medical Detox and Residential treatment services in the heart of South Lyon, MI. With a dedicated team of medical and therapeutic professionals, we offer 24/7 support during detox, individualized treatment plans for lasting recovery, and expertise in addressing the underlying symptoms of addiction. Our 30+ acre campus offers evidenced-based treatment in a structured and spacious environment. We offer a wide variety of therapeutic, recreational, and mindfulness services to promote the healing process. Our goal is to treat individuals, educate their families, and promote health through healing the mind, body, and spirit. Required Skills & Qualifications: Must have graduated from accredited Nursing school. Active license (RN, LPN, PA) as required by the State of Michigan. Eligible to practice Nursing in accordance with the State of Michigan requirements. Minimum of one year working in Behavioral Health (Substance abuse or Psych.) Up to date BLS certification. Ability to pass a drug test and background check. Excellent communication skills. Knowledge of health care regulations- State, Federal, and JCAHO. Negative TB test upon hire. CIWA, COWS, and Withdrawal Symptom Recognition. Responsibilities: Must uphold HIPAA compliance and confidentiality. Assessing new patient's physical and behavioral health needs at time of admission through Nursing Assessment, CIWA/ COWS, and Vitals. Ensure that Initial Nursing Assessment is documented in the EMR and signed on date of admission. Collaborate with Medical Director on findings and coordinating appropriate treatment plan goals based on patient's behavioral health needs. Maintain medical records, educate patients, and patient's families regarding behavioral health conditions. Ensure patient's status is assessed daily with Q-30 rounds for Detox patients and Q-hourly rounds for Residential patients. Provide nursing care and services within the standards and scope of nursing practice as defined within the State's Nurse Practice Act regulations, policies, and procedures. Ensure Medical Director's orders are accurately entered in the EMR. Notify physician of significant changes in withdrawal symptoms, elevated CIWA, elevated COWS, irregular vital signs, medical emergency, change in response to medications, and related challenges. Demonstrate knowledge and application of universal precautions in providing direct patient care. Accurately administer medications per order from physician. Demonstrate accurate count of controlled substance medication administration on necessary documents. Accurate labeling of Look-alike Sound Alike (LASA) medications per facility policies and procedures. Assist with inventory of medications upon client arrival. Ensure Release of Information for previously prescribing providers is on file for continuity of care with ongoing medications. Exhibit therapeutic rapport with patients by maintaining professional boundaries, respecting privacy, providing direct attention to patients, and maintaining rational detachment. Communicate therapeutically and professionally with patients, visitors, colleagues, and others involved at the facility.

Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************

Travel OR RN is needed for 13 weeks to start ASAP in a facility in Michigan. 2+ years of OR experience is required. BLS is required. Shifts consist of Every weekend Friday, Saturday, and Sunday. 7pm-7:30am. EMR used is paragon. Must be able to Circulate. Must be experienced with Ortho, General, GYN, Urology, and Neuro is required. Experience with Pediatric-Geriatric populations is required. Trauma Level 2 experience is highly preferred. Number of Operating rooms: 7 suites. Cases: All areas of surgical specialties are represented, except open-heart surgery. To speak with a recruiter please call Ventura Medstaff today at **************.

Are you ready to take your Travel career to the next level? See places you have not seen before? Ventura's MedStaff tenured Recruiters are here to help you find your ideal contract; with over 50 years of combined experience. Markets have changed, but Ventura MedStaff has maintained a leader in the forefront of Therapy, Allied and Nursing opportunities. Our recruiters are here to help answer your questions and provide you with the most up to date information. Contracts run 8-13 weeks, with 36-40-hour guarantees, flexible start dates, and a mix of schedules. Contact one of our dedicated Recruiters to discuss more details. Ventura MedStaff benefits represent the care and compassion we provide for our clients. • Health, dental, vision, life, disability benefits and 401k • Tax free stipends when applicable • Gym discounts • Weekly pay • $750.00 referral bonus Please apply or contract us at: *********************** or ************

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines Provider appeals and Utilization reviews and assist with Denial Letters Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team. Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures. Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care. Qualifications Must be an RN Utilization Review background in either Managed Care of Provider environment (at least one year) Interqual experience Other basic computer skills necessary: Microsoft Office, Data Entry, etc. Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management. Also has a background in patient, skilled nurses facilities, rehab, and home healthcare. Additional Information Are you an experienced RN looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career In Nursing by joining a rapidly growing company? If you answered “yes" to any of these questions - this is the RN position for you! If you are interested, reach out to me (Krishna) at 321-574-6926 The greatest compliment to our business is a referral.If you know of someone looking for a new opportunity, please pass along my contact information!

Advantmed is a leading provider of risk adjustment, quality improvement and value-based solutions to health plans and providers. We drive market leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners. Our solutions focus on identifying, managing, and documenting risk and quality performance, and the proactive clinical engagement of high acuity populations. The building B.L.O.C.K.S. of our team's success! Bring the fun Leverage together for better Outperform yourself Care at every touchpoint Keep your word. Keep it real Stay curious & listen well Primary Purpose: We are proud of the quality care we provide members, and our team is rapidly expanding to meet the demands of our growing business; we are seeking a highly skilled and compassionate certified Nurse Practitioner to join our Advantmed provider network. In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at-risk populations. Your primary objective will be to assess the overall health and well-being of member beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care. This role is 1099 (PRN) and offers tremendous flexibility and opportunity for those who are balancing competing priorities. Learn more about our primary purpose here Follow us on LinkedIn: ****************************************** NP Responsibilities: In-home Clinical Assessments Travel to members' homes and conduct comprehensive health evaluations Conduct Annual Wellness Visits and health assessments for members with chronic conditions. Perform: Medical history and physical examinations Review of systems Vital signs collection Medication review and reconciliation Possible preventive health screenings Hemoglobin A1C Spirometry KED (Kidney Health Evaluation) DRE (Diabetic Retinal Exam) FIT Patient Education & Engagement Deliver preventive health education and counseling opportunities. Educate patients on ongoing health monitoring, medication adherence, and chronic condition management. Support informed decision-making and ensure true, informed consent. Engage in goals of care discussions when appropriate. Care Coordination & Quality Support Identify clinically relevant diagnoses for care management and risk adjustment documentation. Communicate findings used to generate post visit summaries for the primary care provider. Identify and help close quality care gaps (e.g., screenings, labs, follow-ups). Collaborate enthusiastically with the broader care team to enhance clinical quality and patient experience. Compliance & Professional Standards Adhere to HIPAA regulations and safeguard protected health information (PHI). Maintain accurate, timely, and compliant EMR documentation. Perform additional duties as assigned in alignment with organizational goals. An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Washtenaw County, Michigan Requirements Travel Requirements Daily travel expectations remain within a 55-mile radius of the assigned home location. NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in This role requires travel up to a maximum 55-mile radius originating in the assigned job posting county Preference is given to weekday schedules Preference is given to standard working hour schedules Previous in-home risk assessment experience preferred Previous 1099 (PRN) experience is preferred but not required 3 years patient care experience preferred (primary care/adult/geriatric, EMR) May be requested to obtain additional NP licensure supported by Advantmed Access to reliable transportation that will enable you to travel to members' homes within a designated area Strong ability to work within our EMR system Ability to work independently Bilingual is a plus Benefits Advantmed offers: Competitive compensation of ~$100 per completed in-home health assessment Paid mileage Flexible work schedule, choose your own schedule No on call Visits ready to be scheduled immediately Appointment confirmation support Dedicated coordinator support Advanced member scheduling coverage State of art technology

Hospitals on Incredible Health are actively hiring and accepting applications in the Grand Blanc, MI area for the following position: Nurse Case Manager (RN). Nurses with experience in any of the following areas are strongly encouraged to apply: Clinical pathway, Navigator, or Utilization Review. Shift(s) available: day shift, night shift, and mid shift Job types available: full time, part time, and per diem Employer features: Adoption Assistance, Child Care Benefits, Cross training, Disability Insurance, EAP, Family Care Benefits, Health Insurance, Level 2 trauma center, Life Insurance, Medical, Paid Parental Leave, Phone Plan Discount, PTO, Retirement Plan, Tuition Assistance, Union facility, U.S. News best hospital, Visa Sponsorship Qualifications: Bachelor of Science in Nursing (BSN) or higher educational attainment from an accredited program Active and unencumbered Registered Nurse license 1+ years experience in case management, preferably within a healthcare or hospital setting Exceptional interpersonal and communication skills, both written and verbal, to effectively collaborate with medical professionals, patients, and family members Proficiency in electronic health records (EHR) software Responsibilities: Conduct comprehensive assessments of patients, including their medical history, medication, treatment plans, and psychosocial needs Collaborate closely with healthcare providers, patients, and families to develop and implement individualized care plans Monitor and evaluate patient progress, adjusting care plans as needed and communicating any changes to the healthcare team Serve as the main point of contact between the patient and healthcare providers, ensuring seamless communication and care coordination Maintain up-to-date records and case notes, adhering to all confidentiality and compliance standards Benefits: Healthcare coverage: Medical, Dental, Vision 401K Paid Time Off Tuition Assistance Salary: $72,470 to $111,200 /year