• Medical Claim Review Nurse (RN)

    Molina Healthcare (Warren, MI)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified Professional in Healthcare… more
    Molina Healthcare (09/06/25)
    - Related Jobs
  • Regional Manager Denial Management…

    McLaren Health Care (Grand Blanc, MI)
    …of Medicine Degree **.** **4 years of utilization management, case management, clinical documentation, and/or denials/ appeals experience in an acute healthcare ... trends and direction to assist front-end processes such as utilization management, clinical documentation improvement, coding, and billing etc. to reduce denials. 4.… more
    McLaren Health Care (09/26/25)
    - Related Jobs
  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan Upon Hire required...(BLS) - ARC American Red Cross preferred + Case Manager , Certified (CCM) - CCMC Commission for Case … more
    Corewell Health (09/19/25)
    - Related Jobs