1416 Rn Case Manager jobs in Detroit,MI

Medical Review Nurse (RN)

Molina Healthcare

Detroit, MI 48233

At least 2 years clinical nursing experience, including at least 1 year of utilization review, medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience.
Registered Nurse (RN). License must be active and unrestricted in state of practice.
Microsoft Office suite and applicable software program(s) proficiency.
Effective verbal and written communication skills.
Organizational and time-management skills.
Attention to detail.
Critical-thinking and active listening skills.
Experience demonstrating knowledge of ICD-10, Current Procedural Technology (CPT) coding and Healthcare Common Procedure Coding (HCPC).
Analytic, problem-solving, and decision-making skills.
Common look proficiency.
Experience working within applicable state, federal, and third-party regulations.

Henry Ford Health System

Detroit, MI 48228

CVS Health

Detroit, MI 48228

DMC Children's Hospital of Michigan

Detroit, MI 48228

Chamberlain University

Detroit, MI 48228

An unencumbered professional RN nursing license in Michigan
Illinois RN License will be required to teach all courses (course assignments prioritized to professors who are currently licensed in Illinois)
Active BLS certification (American Heart Association, American Red Cross, or Military Training Network)
At least two years professional experience within last five years in the area of instruction as a registered nurse
A master's or doctoral degree in Nursing from a regionally accredited college or university