• RN Clinical Appeals Nurse…

    Molina Healthcare (Warren, MI)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... a plus. Work hours: Monday - Friday 8:00am- 5:00pm Remote position **Essential Job Duties** * Performs clinical...reviews of previously denied cases in which a formal appeals request has been made or upon request by… more
    Molina Healthcare (01/02/26)
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  • Clinical Registered Nurse…

    Cognizant (Lansing, MI)
    …cycle or clinic operations + Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and concurrent reviews + ... Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...stand out** + Epic experience + Experience in drafting appeals disputing inpatient clinical validations audits is… more
    Cognizant (12/23/25)
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  • Utilization Management Nurse - LPN/LVN

    Integra Partners (Troy, MI)
    …of UM authorization reviews, both verbally and in writing + Process administrative and clinical appeals and refer as needed to the Medical Director + Maintain ... care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating… more
    Integra Partners (11/21/25)
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  • Care Review Clinician (RN)

    Molina Healthcare (Warren, MI)
    For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is a Remote position, home office with internet connectivity of ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. JOB DESCRIPTION Job SummaryProvides support for … more
    Molina Healthcare (12/24/25)
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