• Utilization Management Nurse

    CVS Health (Lansing, MI)
    … solutions that promote high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. **Position ... + 5+ years of clinical practice experience in medical healthcare. + 3+ years Medical Review or Utilization Management experience. + 2+ years of experience… more
    CVS Health (09/24/25)
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  • RN , Manager, Utilization

    Humana (Lansing, MI)
    …areas. **Use your skills to make an impact** **Required Qualifications** + An active, unrestricted Registered Nurse ( RN ) license in the state of Michigan. + ... Previous experience in utilization management and/or utilization review . + Minimum of two (2) years of proven experience in management or leadership… more
    Humana (09/28/25)
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  • RN Case Manager: University Hospital (Care…

    University of Michigan (Ann Arbor, MI)
    …as Allscripts + Participate in venues to reduce barriers to discharge ** Utilization Review and Utilization Management ** + Conduct clinical review on ... RN CASE MANAGER: University Hospital (Care Management...is unique in that it combines clinical/quality considerations with regulatory/financial/ utilization review demands. The position creates a… more
    University of Michigan (09/16/25)
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  • Complex Care - Registered Nurse Case…

    Henry Ford Health System (Detroit, MI)
    …+ Proficiency with computers, electronic health records (EHR), database systems, and utilization review /case management documentation systems. + Knowledge of ... available for qualified experienced candidates with current 2 years RN Case Management in a large acute...work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a… more
    Henry Ford Health System (08/19/25)
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  • Case Manager Registered Nurse

    McLaren Health Care (Flint, MI)
    …services. + Two (2) years clinical nursing experience. + One (1) year previous case management or utilization review experience. **Preferred:** + BSN. + Two ... We are looking for a Case Manager, RN to join us in leading our organization...(2) years' experience in Managed Care Utilization Management , Medical Management more
    McLaren Health Care (09/22/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    management , utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... all hospitalized patients. + Identifies patients that need care management services (ie utilization review ;...accredited school of nursing. + Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing… more
    Corewell Health (09/23/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... all hospitalized patients. 1. Identifies patients that need care management services (ie utilization review ;...accredited school of nursing. + Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing… more
    Corewell Health (08/25/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Ann Arbor, MI)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing....Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (09/05/25)
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  • Registered Nurse Denial Appeals…

    McLaren Health Care (Grand Blanc, MI)
    …Three years of recent case management , clinical documentation, or utilization review experience + Five years of clinical nurse experience in an acute ... 8. Educates health team colleagues about complex clinical appeals, utilization review , including role, responsibilities tools, and...and directed. **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's… more
    McLaren Health Care (09/30/25)
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  • Care Review Clinician, Prior Authorization

    Molina Healthcare (Ann Arbor, MI)
    …**JOB QUALIFICATIONS** **Required Education** Any of the following: Completion of an accredited Registered Nurse ( RN ), Licensed Vocational Nurse (LVN) ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse...Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and… more
    Molina Healthcare (09/18/25)
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