• Registered Nurse - Community Care

    Veterans Affairs, Veterans Health Administration (Detroit, MI)
    Summary The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible for executing a streamlined approach to receiving, triaging, and directing ... of clinical experience. Duties: The Community Care (CC) Coordinator Registered Nurse ( RN ) is responsible...intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards,… more
    Veterans Affairs, Veterans Health Administration (10/08/25)
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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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  • Case Manager Registered Nurse

    CVS Health (MI)
    …Configures the case management system to organize cases dealing with disease management and utilization review ; tracks patient progress and manages ... reimbursed per our company expense reimbursement policy **Preferred Qualifications** + Case Management experience + Compact RN licensure + Certified Case Manager… more
    CVS Health (10/03/25)
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  • Integrated Care Management Assistant Case…

    McLaren Health Care (Petoskey, MI)
    …**_Preferred:_** + Associate degree in healthcare related field + Two years of case management or utilization review experience + Three years of recent ... Responsible for providing assistance to the RN and SW Care Managers in the coordination...patients, colleagues and community. 5. Performs concurrent and retrospective utilization management -related activities and functions to ensure… more
    McLaren Health Care (09/26/25)
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  • Dialysis Clinical Manager Registered

    Fresenius Medical Center (Sandusky, MI)
    …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
    Fresenius Medical Center (10/02/25)
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  • Medical Claim Review Nurse

    Molina Healthcare (Warren, MI)
    …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years… more
    Molina Healthcare (09/06/25)
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  • Manager- Certified Registered Nurse

    Henry Ford Health System (Detroit, MI)
    The Certified Registered Nurse Anesthetist (CRNA) Manager is a Certified Registered Nurse Anesthetist who ensures the delivery of safe anesthetic patient ... activities in accordance with regulatory and accrediting organizations. . Hires certified registered nurse anesthetists for the department. Accepts input on… more
    Henry Ford Health System (08/27/25)
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  • RN Case Manager

    Trinity Health (Chelsea, MI)
    …Type:** Part time **Shift:** Rotating Shift **Description:** ** Registered Nurse ** **Case Manager** **Department:** Utilization Management **Location:** ... + Tuition Reimbursement **Position Purpose:** Exceptional opportunity for a Registered Nurse Case Manager to support our...use of care plans, critical pathways, managed care, and utilization review processes and collaboration with all… more
    Trinity Health (09/03/25)
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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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  • Registered Nurse , Per Diem, At Risk…

    Pine Rest Christian Mental Health Services (Grand Rapids, MI)
    …availability will be variable based on staffing needs. What Will You Do? As a Registered Nurse at Pine Rest, you'll be part of tight-knit team that believes ... ultimately help participants live in a more independent setting. RN Shifts available for pick up are 12 hours,...assignments and promoting staff development. + Responsible for the utilization and continued review of patient care… more
    Pine Rest Christian Mental Health Services (08/09/25)
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