- Henry Ford Health System (Warren, MI)
- …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... Management experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State of Michigan License.… more
- Cognizant (Lansing, MI)
- …to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,… more
- Molina Healthcare (Grand Rapids, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...Further details to be discussed during our interview process. Remote - requires RN license Work schedule: Saturday… more
- Molina Healthcare (Ann Arbor, MI)
- …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...Friday 8:00am- 5:pm with rotational weekend and holiday coverage Remote position MA RN licensure required **Essential… more
- Molina Healthcare (Detroit, MI)
- For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review ... 8 AM to 5 PM EST This is a Remote position, home office with internet connectivity of high...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Molina Healthcare (MI)
- …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
- Molina Healthcare (Detroit, MI)
- … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... (Team will work on set schedule) Looking for a RN with experience with appeals, claims review ,...clinical nursing experience, including at least 1 year of utilization review , medical claims review ,… more
- Molina Healthcare (Detroit, 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 ... (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
- CVS Health (Lansing, MI)
- …shift times are not permitted. **Required Qualifications** + Active unrestricted state Registered Nurse licensure in state of residence required. + Minimum ... promote high-quality healthcare for members. **Position Summary** Join our Utilization Management team as a Nurse Consultant,...experience in Nursing. + At least 1 year of Utilization Management experience in concurrent review or… more
- University of Michigan (Ann Arbor, MI)
- …as assigned DAILY WORK DUTIES 1. Insurance Alert Changes from software system for utilization management: notify RN CM if additional clinicals are required 2. ... Utilization Management Assistant (Patient Services Intermediate) Apply Now...retirement savings **Responsibilities Essential: 1. Data entry of clinical review information for online authorizations into multiple web sites… more