Utilization review nurse jobs in Detroit, MI

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

**Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. _Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law._ **Work Schedule:** Monday to Friday from 9:00 AM to 5:30 PM EST, with 2-4 late evening shifts per month from 11:30 AM to 8:00 PM EST. The **Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Perform duties telephonically or on-site such as at hospitals for discharge planning. **How you will make an impact:** + Ensures member access to services appropriate to their health needs. + Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. + Implement care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. + Coordinates internal and external resources to meet identified needs. + Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. + Negotiate rates of reimbursement, as applicable. + Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care management policies and procedures. **Minimum Requirements:** + Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. + Current unrestricted RN license in applicable state(s) required. + Multi-state licensure is required if this individual provides services in multiple states. **Preferred Experience, Skills, and Capabilities:** + Certification and experience as a Case Manager is preferred. + BS in a health or human services related field preferred. + Experience in telephonic case management, especially for complex and chronic care needs is strongly preferred. + Preferred proficiency with telephonic systems and health information technology. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $76,944 to $115,416. Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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 seeking a highly skilled and compassionate 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 and other 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. NP Responsibilities: Perform annual wellness visits and health assessments on a population with chronic conditions Deliver patient health education opportunities Assist in closing quality care gaps (i.e. screenings and labs) An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Macomb County, Michigan Requirements NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in Previous in-home Risk Assessment experience preferred 3 years patient care experience preferred (primary care/adult/geriatric, EMR) Bilingual is a plus Benefits Advantmed offers: Competitive wages (contractor per diem, per completed in-home assessment rate ~$100) Paid mileage Flexible work schedule Evening and weekend availability 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.

Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. Location Ann & Robert H. Lurie Children's Hospital of Chicago Job Description Must have 3 years of inpatient peds experience to be considered for an interview. Diabetes care and education exp. preferred. Candidates will work 4 10-hour shifts M-F (5 8s are also acceptable). Support of providers in Northwest Satellite locations and Downtown - Schaumburg, Northbrook, Clark-Deming/Main Campus General Summary: The Ambulatory Nurse coordinator as part of a multi-disciplinary team and under the general supervision of the Division Head/Medical Director of the program, coordinates the activities of the service which pertain to the division, outreach, and community education. The Ambulatory Nurse coordinator promotes and facilitates optimal care and works with a diverse group of individuals including families, physicians, nurses, donors, Foundation Staff, Institutional Review Board, and community-based organizations, as well as other hospital staff through clinical, administrative, professional, educational, and quality improvement activities. Essential Job Functions: * Coordinates the specific program activities which pertain to the division which pertain to the division including clinical, education, and research. * Completes assessments, identifies goals and objectives for performance improvements and develops care plans in order to provide the best patient care, optimum customer service and improve overall satisfaction. * Participates in the development, implementation and ongoing assessment of policies, procedures and guidelines that define the patient population. * Develops and manages clinical databases to develop and track key performance indicators. * Establishes and maintains rapport among a group of diverse health care providers, as well as maintaining an effective working relationship with these individuals. * Acts as liaison between the division and community-based programs. * Transitions the patient from the inpatient to the outpatient setting when appropriate. Supporting patient education for the clinical diagnosis as well as educating families on community resources which are available. * Documents and communicates all team, physician and patient/family communication and concerns pertaining to the coordinator of care and services in the medical record. * Acts as resource to hospital personnel regarding care, coordination and evaluation of patients in the division. * Participates, plans, implements and disseminates research and/or quality improvement projects * Provides education to nurses, patients, families, residents, physicians and ancillary healthcare workers in the hospital and community setting. * Maintains current knowledge of care of the patient population via professional societies, literature and educational conferences. * Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others. * Other job functions as assigned. Knowledge, Skills and Abilities: * A BSN degree from an accredited school of nursing is required. A master's degree from an accredited school of nursing is preferred. * Current licensure as a registered professional nurse in the State of Illinois required. * A minimum of 3 years of pediatric nursing experience required. * The ability to effectively communicate with patients/families, physicians, hospital staff, social agencies, school personnel and community resources. * Excellent organizational skills, including ability to effectively manage multiple competing responsibilities. * Previous successful experience in new program development, coordination and marketing. * High level of initiative and autonomy * Proficient in a variety of computer programs, including Word, Excel, PowerBI, and PowerPoint and working knowledge of Epic. * BLS required. Lurie Children's will consider visa sponsorship of qualified candidates for the registered nurse role, subject to all applicable law as well as business and budgetary limitations. Education Bachelor's Degree: Nursing (Required) Pay Range $83,200.00-$137,280.00 Salary At Lurie Children's, we are committed to competitive and fair compensation aligned with market rates and internal equity, reflecting individual contributions, experience, and expertise. The pay range for this job indicates minimum and maximum targets for the position. Ranges are regularly reviewed to stay aligned with market conditions. In addition to base salary, Lurie Children's offer a comprehensive rewards package that may include differentials for some hourly employees, leadership incentives for select roles, health and retirement benefits, and wellbeing programs. For more details on other compensation, consult your recruiter or click the following link to learn more about our benefits. Benefit Statement For full time and part time employees who work 20 or more hours per week we offer a generous benefits package that includes: Medical, dental and vision insurance Employer paid group term life and disability Employer contribution toward Health Savings Account Flexible Spending Accounts Paid Time Off (PTO), Paid Holidays and Paid Parental Leave 403(b) with a 5% employer match Various voluntary benefits: * Supplemental Life, AD&D and Disability * Critical Illness, Accident and Hospital Indemnity coverage * Tuition assistance * Student loan servicing and support * Adoption benefits * Backup Childcare and Eldercare * Employee Assistance Program, and other specialized behavioral health services and resources for employees and family members * Discount on services at Lurie Children's facilities * Discount purchasing program There's a Place for You with Us At Lurie Children's, we embrace and celebrate building a team with a variety of backgrounds, skills, and viewpoints - recognizing that different life experiences strengthen our workplace and the care we provide to the Chicago community and beyond. We treat everyone fairly, appreciate differences, and make meaningful connections that foster belonging. This is a place where you can be your best, so we can give our best to the patients and families who trust us with their care. Lurie Children's and its affiliates are equal employment opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity or expression, religion, national origin, ancestry, age, disability, marital status, pregnancy, protected veteran status, order of protection status, protected genetic information, or any other characteristic protected by law. Support email: ***********************************

Requirements RN Degree, BSN Preferred Advanced certification in specialty areas of practice (e.g., CRNI, ONS, IgRN) preferred but not required. On-Call Requirement: This position requires participation in an on-call rotation, nights and weekends included, providing as-needed support outside of regular business hours to address urgent issues and ensure continuous operations. Administrative Oversight: Responsible for providing administrative oversight, including monitoring of workflows, ensuring compliance with policies, and managing resources efficiently to meet organizational objectives. Emergency Availability: Must be available to respond promptly to emergencies, ensuring rapid and effective resolution of issues to minimize impact on operations. Availability during non-standard hours, including nights, weekends, and holidays, as required by the nature of the emergency. Minimum 3 years nursing experience with background in infusion therapy preferred. Current nursing license for applicable home state Experience in ICU and/or Cardiac Care preferred. Proficient with Microsoft Outlook and Microsoft Office Suite. Valid state issued driver's license with no significant restrictions on that license. About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! Soleo's Core Values: Improve patients' lives every day Be passionate in everything you do Encourage unlimited ideas and creative thinking Make decisions as if you own the company Do the right thing Have fun! Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture. Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor. Keywords: Nursing, clinic, clinical, IV, patient care, CPR, Acute, outpatient, pharmacy, Emergency room, ICU, home care, internal medicine, GI, neuro, rheumatology, adult, registered nurse, PACU, chronic, home health, Hospice, Acute Care, Critical Care, CRNI, ER, blood products, IVIG, Biologics, TPN, step down, now hiring, hiring now, immediately hiring, hiring immediately, Vascular Access Nurse, Infusion, Specialty Infusion Pharmacy, IV Therapy, IV Infusion, Home Infusion, IV Therapy Administration, Home Infusion Therapy, Specialty Infusion Nursing, Specialty Infusion, RN Clinical Liaison, Infusion Nurse Liaison, CPR+, Alayacare

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

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

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.

Integro Asset Management is a management company that specializes in the areas of skilled nursing, assisted living, and memory care in senior living communities located in various states located across the US. Integro's goal is provides a serene setting and compassionate care to our senior living and memory care residents. At Integro we are dedicated to Enhancing Quality of Life. We are looking for an experienced Quality Assurance Nurse to serves as an integral part of the multidisciplinary team overseeing all quality related activities across the health care setting. This will be a remote position that will require travel. General Purpose The Regional Quality Assurance Nurse serves as an integral part of the multidisciplinary team overseeing all quality related activities across the communities. The Regional Quality Assurance Nurse is primarily responsible for providing leadership, support, and direction to multiple healthcare communities. The Regional Nurse oversees all clinical operations of the facilities in their region, ensures that company policies and procedures are carried out and that regulatory compliance standards are being met. The Regional Nurse ensures optimal utilization of resources and compliance with the operating standards of various health care governing and accrediting bodies. The position of Regional Nurse is as much a support role, as it is a leadership role. Regional Nurses work alongside the management teams at each facility to develop and implement processes, identify and resolve issues. The qualifications of a Regional Nurse generally include: Qualifications: Bachelors in Nursing A minimum of five (5) years' experience as a Professional Nurse and maintains a current state license as a Registered Nurse (RN) At least 5 years nursing management experience in assisted living, skilled nursing or long-term care environments Proficiency in computer skills, Microsoft Office (Windows, Outlook, Excel) with the ability to learn new applications Able to travel within a geographic area or on assignments Demonstration of competence in assessment skills and know how to recognize and implement the standards that protect brand integrity through all services knowledge of local, state, and federal regulatory compliance standards and medical practices within the scope of long-term care. Minimum five (5) years experience in the Performance Improvement discipline in a long term care facility with a successful track record and demonstrated progressive management. (preferred) Responsibilities: Works with nursing leadership across facilities to ensure regular clinical competency verification of nursing staff Conducts Root Cause Analyses for clinical adverse events and near miss events; develops action plans to reduce risk of recurrence; follows the progress of these action plans Identifies areas of potential risk and develops systems within the organization to minimize risk of adverse events or negative quality outcomes Conduct annual and complaint survey preparation Performs other duties as requested by leadership team Quality monitoring of services, training, regulatory compliance and implementation of resident care policies, forms and systems Coordinates the development and integration of a "dashboard" for clinical outcomes, critical interventions, cost, utilization, satisfaction, etc. Continuously assesses the organization's compliance with external regulatory bodies Performs all other duties as requested by leadership Members of our team Enjoy: Working with a highly engaged staff Healthy staffing levels Flexible scheduling Career growth Competitive compensation

At Reproductive Medicine Associates of Michigan, we are proud to be one of the top fertility practices in the United States, with a mission to help individuals and couples build their families. For 18 years, our team of dedicated physicians, nurses, and staff has worked together toward the common goal of bringing hope to our patients. We are committed to offering compassionate care, expert advice, and unwavering support when our patients need it most. If you share our passion for helping others and making a meaningful difference in their lives, we invite you to join our exceptional nursing team! Position Overview: As an IVF Nurse, you will play a key role in guiding patients through their fertility treatment journey. You will provide education, coordinate care, and offer emotional support to help patients achieve their dream of starting or expanding their families. Responsibilities: Serve as a Treatment Care Coordinator for fertility patients and couples Case management and clinical treatment of fertility patients Extensive patient education about ART (Assisted Reproductive Technology) and infertility treatments Counsel patients during initial visits regarding treatment options and next steps Communicate physician orders, instructions, and lab results with clear interpretation Perform telephone triage, addressing medication concerns, treatment plans, lab results, and any patient inquiries Ensure exceptional patient care throughout their IVF treatment cycle Shift Information: Start Time: 6:00 AM Schedule: Four 10-hour shifts, with rotating weekends and holidays After one year, enjoy the flexibility of one remote day per week Job Requirements: Specialization in women's health services is preferred Fertility experience is highly desirable Ability to work independently with strong critical thinking skills Must be comfortable working weekends on rotation Strong leadership abilities and a desire to make a lasting impact on patient care Qualifications: Nursing Experience: At least 2 years (required) License: Must hold an active MI RN license (required) Education: Bachelor of Science in Nursing (BSN) is preferred Why Choose Us? Impactful Work: Play a pivotal role in the fertility journey, helping people realize their dream of parenthood. Collaborative Environment: Work alongside a compassionate, dedicated team focused on providing the best care possible. Professional Growth: Opportunities to grow in a supportive, forward-thinking practice, including flexible work arrangements after one year. If you are passionate about reproductive healthcare and committed to providing the highest level of care, we want to hear from you! Apply today and make a difference in the lives of our patients!

RN/ LPN - Riverview, MI Evaluate assigned patients within the Nursing Facility. Direct the CNAs in their daily care of residents. Currently hiring for midnight shift - 6:45 PM - 7:15 AM. Full or part time positions available. Nurse Duties and Responsibilities include, but are not limited to: Administering medications and other treatments. Assisting physicians during examinations & procedures. Promoting patient's independence based on their care goals. Resolving patient concerns as part of an interdisciplinary team. Examining patients to detect and report issues requiring medical care. Mentor CNAs to build their skill set and foster professional communication. Assign tasks to CNAs to assist with completion of resident ADLs. Communicate with providers, families, guests, visitors, and co-workers professionally and efficiently. Other duties as assigned and within the scope of the profession and license type. Nurse Requirements: State Registered Nurse License/ State Licensed Practical Nurse Valid identification COVID 19 Vaccination or Exemption Comfortable using a computer Excellent customer service a must! Experience: Prior experience in long term care is preferred. Prior experience with Infection Control is preferred. #BF

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 **************.

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! Company: Molina Healthcare Location: 880 Long Lake Rd Suite 600 Troy, Michigan 48098 Shift: Daytime hours Employment: Contract: 1-2 months (possibility of going longer depending on business needs) Company Job Description/Day to Day Duties: 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 Minimum Education/Qualifications/Licensures: 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 Apply now for immediate consideration. After applying, a recruiting consultant will contact you for pre-screening. Please provide your best phone number to contact. Thanks and look forward to hearing from you!

Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work Schedule: Monday to Friday from 9:00 AM to 5:30 PM EST, with 2-4 late evening shifts per month from 11:30 AM to 8:00 PM EST. The Nurse Case Manager II is responsible for care management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Perform duties telephonically or on-site such as at hospitals for discharge planning. How you will make an impact: * Ensures member access to services appropriate to their health needs. * Conducts assessments to identify individual needs and a specific care management plan to address objectives and goals as identified during assessment. * Implement care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. * Coordinates internal and external resources to meet identified needs. * Monitors and evaluates effectiveness of the care management plan and modifies as necessary. Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. * Negotiate rates of reimbursement, as applicable. * Assists in problem solving with providers, claims or service issues. Assists with development of utilization/care management policies and procedures. Minimum Requirements: * Requires BA/BS in a health-related field and minimum of 5 years of clinical experience; or any combination of education and experience, which would provide an equivalent background. * Current unrestricted RN license in applicable state(s) required. * Multi-state licensure is required if this individual provides services in multiple states. Preferred Experience, Skills, and Capabilities: * Certification and experience as a Case Manager is preferred. * BS in a health or human services related field preferred. * Experience in telephonic case management, especially for complex and chronic care needs is strongly preferred. * Preferred proficiency with telephonic systems and health information technology. For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $76,944 to $115,416. Locations: New York In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws. * The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. Job Level: Non-Management Exempt Workshift: Job Family: MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health. Who We Are Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business. We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws. Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

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 seeking a highly skilled and compassionate 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 and other 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. NP Responsibilities: Perform annual wellness visits and health assessments on a population with chronic conditions Deliver patient health education opportunities Assist in closing quality care gaps (i.e. screenings and labs) An enthusiastic collaborator contributing to the enhancement of care delivery Providers are expected to commit a minimum of 30 hours per month Locations: Wayne County, Michigan Requirements NP Qualifications: Must have a valid unencumbered NP License for the state you will be working in Previous in-home Risk Assessment experience preferred 3 years patient care experience preferred (primary care/adult/geriatric, EMR) Bilingual is a plus Benefits Advantmed offers: Competitive wages (contractor per diem, per completed in-home assessment rate ~$100) Paid mileage Flexible work schedule Evening and weekend availability Dedicated coordinator support Advanced member scheduling coverage State of art technology

We are seeking a highly skilled and compassionate Wound Nurse to join our team at Canton. The Wound Nurse will be responsible for providing specialized wound care to patients with acute and chronic wounds. The ideal candidate will have a strong background in wound care and be able to work collaboratively with other healthcare professionals to develop and implement effective treatment plans. Responsibilities: Assess and evaluate patients with acute and chronic wounds Develop and implement individualized treatment plans Provide wound care and management, including dressing changes, debridement, and wound vac therapy Monitor and document patient progress Collaborate with other healthcare professionals to ensure comprehensive patient care Educate patients and their families on wound care and prevention Requirements: Current RN license in the state of Michigan Certification in wound care (WOCN or equivalent) Minimum of 2 years of experience in wound care Excellent communication and interpersonal skills Ability to work independently and as part of a team Strong critical thinking and problem-solving skills

Requirements RN Degree, BSN Preferred Advanced certification in specialty areas of practice (e.g., CRNI, ONS, IgRN) preferred but not required. On-Call Requirement: This position requires participation in an on-call rotation, nights and weekends included, providing as-needed support outside of regular business hours to address urgent issues and ensure continuous operations. Administrative Oversight: Responsible for providing administrative oversight, including monitoring of workflows, ensuring compliance with policies, and managing resources efficiently to meet organizational objectives. Emergency Availability: Must be available to respond promptly to emergencies, ensuring rapid and effective resolution of issues to minimize impact on operations. Availability during non-standard hours, including nights, weekends, and holidays, as required by the nature of the emergency. Minimum 3 years nursing experience with background in infusion therapy preferred. Current nursing license for applicable home state Experience in ICU and/or Cardiac Care preferred. Proficient with Microsoft Outlook and Microsoft Office Suite. Valid state issued driver's license with no significant restrictions on that license. About Us: Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! Soleo's Core Values: Improve patients' lives every day Be passionate in everything you do Encourage unlimited ideas and creative thinking Make decisions as if you own the company Do the right thing Have fun! Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture. Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees. Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor. Keywords: Nursing, clinic, clinical, IV, patient care, CPR, Acute, outpatient, pharmacy, Emergency room, ICU, home care, internal medicine, GI, neuro, rheumatology, adult, registered nurse, PACU, chronic, home health, Hospice, Acute Care, Critical Care, CRNI, ER, blood products, IVIG, Biologics, TPN, step down, now hiring, hiring now, immediately hiring, hiring immediately, Vascular Access Nurse, Infusion, Specialty Infusion Pharmacy, IV Therapy, IV Infusion, Home Infusion, IV Therapy Administration, Home Infusion Therapy, Specialty Infusion Nursing, Specialty Infusion, RN Clinical Liaison, Infusion Nurse Liaison, CPR+, Alayacare

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! Company Job Description/Day to Day Duties: 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 Minimum Education/Qualifications/Licensures: 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 Registered Nurse looking for a new opportunity with a prestigious healthcare company in Troy MI? 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 position for you!