• Registered Nurse Utilization…

    McLaren Health Care (Port Huron, MI)
    …related duties as required and directed. **Qualifications:** Required ⦁ State licensure as a registered nurse ( RN ) ⦁ Bachelor's degree in nursing from ... and participates in the resolution of retrospective reimbursement issues including appeals , PACER authorization, third party payer certification, and denied cases.… more
    McLaren Health Care (11/12/25)
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  • Appeals Nurse

    Evolent (Lansing, MI)
    …**Required** + Minimum of 5 years in Utilization Management, health care Appeals , compliance and/or grievances/complaints in a quality improvement environment- ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...part of a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of… more
    Evolent (12/24/25)
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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 ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (12/24/25)
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  • RN Care Coordinator

    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 ... it relates to disease management, resource utilization, access, discharge planning, quality , service and efficiently across the continuum. This is an interventional… more
    Corewell Health (11/04/25)
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