• RN Clinical Appeals…

    Molina Healthcare (Warren, MI)
    JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals ... health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (01/02/26)
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  • Appeals Nurse

    Evolent (Lansing, MI)
    …to Standard processing, documenting accordingly. + Works closely with the appeals -dedicated Clinical Reviewers to ensure timely adjudication of processed ... for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a...and Preferred:** + 1-3 years' experience and as an RN - **Required** + Minimum of 5 years in… more
    Evolent (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 ... criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization… more
    Corewell Health (10/23/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire ... criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization… more
    Corewell Health (12/29/25)
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  • Appeals Audit Specialist - McLaren Careers

    McLaren Health Care (Mount Pleasant, MI)
    …the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and achieve optimal ... other related duties as required and directed. **Qualifications:** **_Required:_** + Registered Health Information Technician (RHIT), Licensed Practical Nurse … more
    McLaren Health Care (11/11/25)
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  • Director, Home Health Grievances & Appeals

    CenterWell (Lansing, MI)
    …to preserve and recover revenue while maintaining the highest level of clinical and regulatory integrity and compliance. Manages the Denials Management data ... and appeal process. The Director, Home Health Grievances & Appeals assists members, via phone or face to face,...+ Oversee the process for direction and support to clinical and operational leadership regarding Medicare and governmental audit… more
    CenterWell (01/08/26)
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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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  • Director of Home Health Authorizations,…

    CenterWell (Lansing, MI)
    …revenue integrity and patient access. The Director partners closely with clinical leadership, operations, finance, compliance, and IT, and manages both onshore ... onshore and offshore teams. * Coordinate closely with Intake, Clinical Operations, Scheduling, Billing, and Denials teams. ** Clinical...Teams * Revenue Cycle Leadership * Billing, Denials, and Appeals Teams * Compliance, Legal, and Audit * IT… more
    CenterWell (01/08/26)
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