- Molina Healthcare (Ann Arbor, MI)
- … appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of ... these guidelines. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
- R1 RCM (Detroit, MI)
- …identify targeted areas for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position, the base pay ... analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Appeals Supervisor** , you will help support clinicians who conduct a… more
- R1 RCM (Detroit, MI)
- …analytics, AI, intelligent automation, and workflow orchestration. As our **Clinical Coding Appeals Nurse ** , you will help review and interpret medical ... what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical...external compliance deadlines are met. **Required Skills:** + Active Registered Nurse license + Active AHIMA or… more
- Corewell Health (Farmington Hills, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire ... when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and… more
- Corewell Health (Royal Oak, MI)
- …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon ... when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and… more
- University of Michigan (Ann Arbor, MI)
- RN CASE MANAGER: University Hospital (Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors a ... utilization of resources while promoting quality outcomes. **Organizational Relationships** The RN Case Manager reports directly to the Manager of Care Management.… more
- Prime Therapeutics (Lansing, MI)
- …Patient Programs. **Education & Experience** + Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State and/or Compact State Licensure - ... and spreadsheets. + Supports clinical services such as the appeals program. + Participates in meetings and consults with...for work visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5… more
- Integra Partners (Troy, MI)
- …priorities, systems, and workflows in a fast-paced environment. EDUCATION: Active, unrestricted Registered Nurse , Licensed Vocational Nurse , or Licensed ... The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership...plan policies). + Review and process clinical and administrative appeals ; coordinate with Medical Director when required. + Generate… more
- University of Michigan (Ann Arbor, MI)
- …obtaining insurance authorization. + Facilitate timely submission of documentation for appeals . + Schedule and confirm transportation as directed by Care Management ... **Organizational Group** Um Hospital **Department** MM UH CVC Care Mgt RN **Posting Begin/End Date** 8/21/2025 - 9/09/2025 **Salary** $43,680.00 - $56,014.40… more