- Molina Healthcare (Sterling Heights, MI)
- **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This position will support ... appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical/medical reviews of… more
- CenterWell (Lansing, MI)
- …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather... Registered Nurse or Physical Therapist. + 5… more
- Henry Ford Health System (Troy, MI)
- …by the Clinical Director, Appeals and Grievance. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse with current Michigan licensure + Bachelor's Degree in ... GENERAL SUMMARY: The Clinical Manager, Provider Appeals supports appeals team members to plan, direct, evaluate, coordinate, and manage the activities associated… 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
- Corewell Health (Southfield, MI)
- …2 years of relevant experience 2 years of experience in clinical/hospital setting. Required + Registered Nurse ( RN ) - State of Michigan Upon Hire required ... reviews. Coordinates activities involved in the certification, recertification, and concurrent appeals process, conducting referrals for 2nd level review, as needed.… 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
- 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
- State of Michigan (Lansing, MI)
- …Psychologist (LLP); Fully Licensed Psychologist (LP); Licensed Master Social Worker (LMSW); Registered Nurse ( RN ); Licensed Professional Counselor (LPC) + ... Inclusion . Reviews, coordinates and represents the Department on statewide appeals of preadmission screenings/annual resident reviews Medicaid recoveries before the… more