• Licensed Practical Nurse - McLaren…

    McLaren Health Care (Port Huron, MI)
    …Work Times:** 7:00PM-7:30AM **Scheduled Bi-Weekly** **Position Summary:** The License Practical Nurse delivers quality nursing care through the utilization of ... via written and verbal communication. * Participates in the resident care review process and assists in establishing resident goals, problem resolutions, approaches… more
    McLaren Health Care (05/26/25)
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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Sterling Heights, MI)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... For this position we are seeking a (RN) Registered Nurse who must be licensed for the...the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer… more
    Molina Healthcare (08/02/25)
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  • Case Manager Registered Nurse - Specialty…

    CVS Health (Lansing, MI)
    …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
    CVS Health (08/10/25)
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  • Clinical Reviewer, Nurse - 9am -6pm PST

    Evolent (Lansing, MI)
    …quality and cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on ... Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current,… more
    Evolent (08/01/25)
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  • Registered Nurse Per Diem Beechwood

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …staff assignments and promoting staff development. + Responsible for the utilization and continued review of patient care protocols, standards ... incredible work. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit...patient care. RNs provide direction and oversight to other licensed and non- licensed staff. Pine Rest RNs… more
    Pine Rest Christian Mental Health Services (08/09/25)
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  • Registered Nurse , 24 Hrs Weekly, 3rd…

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …staff assignments and promoting staff development. + Responsible for the utilization and continued review of patient care protocols, standards ... Rest (https://www.pinerest.org/inpatient-services/services/older-adult-inpatient-services/) What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit… more
    Pine Rest Christian Mental Health Services (08/09/25)
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  • Physician Assistant/ Nurse Practitioner, CV…

    Corewell Health (Troy, MI)
    …Health. Full-time, Rotating Shifts GENERAL SUMMARY: Physician Assistants (PA) and Nurse Practitioners (NP) are graduates of an accredited educational program and ... are nationally certified and state licensed professionals. The scope of practice is determined by...parking at all of our campuses ESSENTIAL DUTIES: + Utilization of a high degree of discriminative judgement while… more
    Corewell Health (07/25/25)
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  • Physician Assistant/ Nurse Practitioner…

    Corewell Health (Dearborn, MI)
    …graduates of an accredited educational program and are nationally certified and state licensed professionals. The scope of practice is determined by state law and ... parking at all of our campuses Essential Functions + Utilization of a high degree of discriminative judgement while...recognized PA program that is accredited by the Accreditation Review Commission on Education for Physician Assistants and meet… more
    Corewell Health (05/12/25)
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  • Dialysis Clinical Manager Registered Nurse

    Fresenius Medical Center (Romulus, MI)
    …growth, and training to ensure clinical competence and the ability for licensed staff to assume Team Leader responsibilities + Responsible for overseeing performance ... of all licensed personnel, direct patient care staff, reporting indirect patient...+ Accountable for completion of the Annual Standing Order Review and ICD coding. + Checks correspondence whether electronic,… more
    Fresenius Medical Center (06/28/25)
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  • Care Review Clinician, PA (RN) Transplants

    Molina Healthcare (Detroit, MI)
    …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse (RN). **Required Experience** 1-3 years of hospital or medical… more
    Molina Healthcare (07/17/25)
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