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Nursing Jobs in Sterling Heights, MI

Utilization Management Nurse Consultant

$29.10 - $62.32 / hour

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Regular business hours are 8:00 am-8:00 pm EST. Must be available to work any 8 hour shift within this timeframe with start times ranging from 8:00 am-11:30am EST. About Us American Health Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care management solutions that promote high-quality healthcare for members. Position Summary Join our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment and evidence-based criteria to review inpatient and outpatient services. You'll collaborate with providers, authorize care, and escalate cases when needed, all while navigating multiple systems and maintaining accurate documentation. This role suits nurses who thrive in fast-paced environments, are highly organized, and comfortable with computer-based work. Key Responsibilities Apply critical thinking and evidence-based clinical criteria to evaluate outpatient and inpatient services requiring precertification and concurrent review. Conduct clinical reviews via phone and electronic documentation, collaborating with healthcare providers to gather necessary information. Use established guidelines to authorize services or escalate to Medical Directors as needed. Navigate multiple computer systems efficiently while maintaining accurate documentation. Thrive in a fast-paced, high-volume environment with strong organizational, multitasking, and prioritization skills. Perform sedentary work that primarily involves extended periods of sitting, as well as frequent talking, listening, and use of a computer. Flexibility to provide coverage for other Utilization Management (UM) Nurses across various UM specialty teams as needed, ensuring continuity of care and operational support. Participate in occasional on-call rotations, including some weekends and holidays, per URAC and client requirements. Remote Work Expectations This is a 100% remote role; candidates must have a dedicated workspace free of interruptions. Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted. Required Qualifications Active unrestricted state Registered Nurse licensure in state of residence required. Minimum 5 years of relevant experience in Nursing. At least 1 year of Utilization Management experience in concurrent review or prior authorization. Strong decision-making skills and clinical judgment in independent scenarios. Proficient with phone systems, clinical documentation tools, and navigating multiple digital platforms. Commitment to attend a mandatory 3-week training (Monday–Friday, 8:30am–5:00pm EST) with 100% participation. Preferred Qualifications 1+ year of experience in a managed care organization (MCO). Experience in a high-volume clinical call center or prior remote work environment. Education Associate's degree in nursing (RN) required, BSN preferred. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $29.10 - $62.32 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan . No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CMA

Full-time

2 weeks ago

Medical Assistant I Vascular Surgery

Corewell Health Farmington Hills, MI

Corewell Health is offering a $2,000 sign on bonus for external applicants. About Corewell Health Outpatient Clinics Corewell Health operates over 300 outpatient clinics across Michigan, bringing a multitude of care options to the communities that we serve. There are over 40 different types of primary care and specialty practices, which allows those who work in these clinics the opportunity to learn and explore various interests or to specialize in one area. Scope of work As a Medical Assistant with Corewell Health, you'll be a member of our clinical support team and work closely with other healthcare professionals to ensure delivery of the best possible care. You'll be a vital part of our team, making a real difference in the lives of our patients. Under the direction of management and physician leadership, the Medical Assistant performs and oversees functions within scope of practice related to the clinical activities, including but not limited to: maintaining patient flow by assisting and promoting the delivery of health care, performs technical procedures and clinically oriented activities. The Medical Assistant will assist management in achieving office efficiencies in accordance with stated policies/procedures to ensure efficient operations with a focus on supporting physicians, clinical staff and management to promote customer satisfaction. Qualifications Required High School Diploma or equivalent Required Successful completion of a competency-based Medical Assistant training program. May also have LPN, EMT, ER Tech, paramedic certification and relevant experience May consider a nursing student from an accredited registered or licensed practice nurse program after a clinical course of study has begun Preferred Preferred 1 year of relevant experience Working in a physician practice or healthcare setting CRT-Basic Life Support (BLS) - AHA American Heart Association within 30 days Required Or CRT-Basic Life Support (BLS) - ARC American Red Cross within 30 days Required About Us (Corewell Health) People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of more than 60,000 dedicated people – including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities – and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. How Corewell Health cares for you Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here . On-demand pay program powered by Payactiv Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! Optional identity theft protection, home and auto insurance, pet insurance Traditional and Roth retirement options with service contribution and match savings Eligibility for benefits is determined by employment type and status Primary Location SITE - Farmington Hills Hospital- 28050 Grand River Ave - Farmington Hills Department Name Vascular Surgery HOPD - Farmington Hills Prof Svcs Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work Variable Days Worked Monday to Friday Weekend Frequency N/A CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling 616.486.7447.

CPCU Nursing Assistant

Corewell Health Royal Oak, MI

**Sign-on Bonus available!!** $1,500 for full-time positions $750 for part-time positions GENERAL SUMMARY: Provides care to the patient according to the plan of care, unit routine and hospital policy under the direction of a Registered Nurse. UNIT DESCRIPTION: 8 North East and West CPCU makes up a 68-bed unit cardiac step-down unit that provides an intermediate level of care to patients that typically have a cardiac related diagnosis such as coronary artery disease (CAD), congestive heart failure (CHF), myocardial infarction (MI) and heart arrhythmias such as atrial fibrillation (A-fib) and ventricular tachycardia (V-Tach). We also provide pre and post procedure care to patients that have undergone cardiac procedures, such as catheterization/angioplasty, stents, ablations, and placement of pacemakers, and defibrillators. Our nurses receive specialized training in arterial sheath removal and Tikosyn administration and are ACLS certified. All patients are continuously monitored by telemetry. BENEFITS : Corewell Health offers a comprehensive benefits package to meet your financial, health and life-work balance goals. NEW On-demand pay program – powered by Payactiv Generous paid time off, holidays and flexible scheduling Our employees receive special discounts on a wide range of products and services Exceptional health, dental, vision and prescription drug insurance plans Relocation assistance Generous retirement savings, disability insurance, identify theft protection and even home and auto insurance Free onsite parking at all campuses STANDARD QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential duties. Education / Training: High school graduate or equivalent Work Experience: Previous hospital or nursing home experience preferred Certification, Licensure, Registration: American Heart Association or American Red Cross Basic Life Support required Current CNA certification preferred Other Qualifications: Ability to communicate effectively and document information accurately. Ability to deal efficiently and effectively with a wide variety of individuals. Knowledge of basic medical terminology preferred. Basic computer knowledge is preferred. Ability to move or lift patients and equipment. Ability to demonstrate Beaumont customer service standards and behaviors in all aspects of job performance ESSENTIAL DUTIES: Providing care to the patient according to the plan of care, specific unit routines and hospital policy under the Direction of the Registered Nurse. Documentation of care provided in the electronic medical record. Safe transport of patients via wheelchair or stretcher, dispatch services and appropriate documentation of services. Provides the services of an Observer for any patient on a patient care unit who has been assessed to require constant observation, either in person or via remote video monitoring, to maximize his/her safety. Performs general receptionist and clerical duties to facilitate efficient functioning of the nursing unit. Maintains current knowledge/certification. Attends all required Safety Training programs and can describe his/her responsibilities related to general safety, department/service safety and specific job-related hazards. Follows the Hospital Exposure Control Plans/Bloodborne and Airborne Pathogens. Demonstrates respect and regard for the dignity of all patients, families, visitors and fellow employees to ensure a professional, responsible and courteous environment. Promotes effective working relations and works effectively as part of a department/unit team inter and intra departmentally to facilitate the department's/unit's ability to meet its goals and objective. This document represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described. Corewell Health People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency. Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of more than 60,000 dedicated people – including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities – and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness. Corewell Health William Beaumont University Hospital Corewell Health William Beaumont University Hospital opened on January 24, 1955, as a 238-bed community hospital. Today, the hospital serves as the largest hospital in the Corewell Health network. This is a 1,131-bed major academic and referral center with Level I adult trauma and Level II pediatric trauma designations. Corewell Health William Beaumont University Hospital has 44 residency and fellowship programs with 481 residents and fellows. We are the exclusive clinical partner of the Oakland University William Beaumont School of Medicine with more than 1,400 doctors on faculty. The advanced capabilities and clinical expertise within this center have earned us Magnet® designation four consecutive times, the distinction of being Michigan’s first Diagnostic Imaging Center of Excellence, and recognition as the #2 hospital in Michigan and one of the top hospitals in the country by U.S. News & World Report. This is where extraordinary begins. Find out where it can take you and your career. Apply Now! How Corewell Health cares for you Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here . On-demand pay program powered by Payactiv Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more! Optional identity theft protection, home and auto insurance, pet insurance Traditional and Roth retirement options with service contribution and match savings Eligibility for benefits is determined by employment type and status Primary Location SITE - Royal Oak Hospital - 3601 W 13 Mile Rd - Royal Oak Department Name Progressive Care Unit Cardiac 8NW - Royal Oak Hosp Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work 6:30 pm -6:30 am Days Worked Monday to Friday Weekend Frequency Every third weekend CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only. Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief. Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category. An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team. You may request assistance in completing the application process by calling 616.486.7447.