• 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 (11/08/25)
    - Related Jobs

  • RN Utilization Review…

    Corewell Health (Caledonia, MI)
    …acute care, clinical nursing, preferably multiple clinical settings, or related experience Required + Registered Nurse ( RN ) - State of Michigan required How ... Must live in MICHIGAN and have MICHIGAN RN LICENSE Scope of Work: Provides health information, interacts and acts as a resource for nursing units for complex… more
    Corewell Health (12/02/25)
    - Related Jobs

  • Registered Nurse - Marwood Rehab…

    McLaren Health Care (Port Huron, MI)
    …7:00PM-7:30AM **Scheduled Bi-Weekly Hours:** 72 **Position Summary:** The Registered Nurse delivers quality nursing care through the utilization of the ... and verbal communication. + Participates in the resident care review process and assists in establishing resident goals, problem...+ Associates degree from an accredited university + Valid RN licensure from the State of Michigan + CPR… more
    McLaren Health Care (11/15/25)
    - Related Jobs

  • * RN Coordinator- Utilization…

    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
    Henry Ford Health System (09/25/25)
    - Related Jobs

  • Utilization Management Nurse…

    Integra Partners (Troy, MI)
    …priorities, systems, and workflows in a fast-paced environment. EDUCATION: Active, unrestricted Registered Nurse , Licensed Vocational Nurse , or Licensed ... The Utilization Management (UM) Nurse Supervisor is...payer or managed care environment. + Strong understanding of utilization review , authorizations, and appeals processes. +… more
    Integra Partners (11/27/25)
    - Related Jobs

  • Utilization Management Nurse

    CenterWell (Lansing, MI)
    …community and help us put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers in reviewing actual and proposed ... medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that focuses on excellent… more
    CenterWell (11/22/25)
    - Related Jobs

  • Care Review Clinician ( RN )

    Molina Healthcare (Grand Rapids, 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 (11/23/25)
    - Related Jobs

  • RN UM Clinical Appeals Nurse Remote

    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 (11/14/25)
    - Related Jobs

  • Care Review Clinician ( RN )

    Molina Healthcare (Detroit, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... unit (ICU) or emergency room. Previous experience in managed care Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
    Molina Healthcare (11/27/25)
    - Related Jobs

  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Sterling Heights, MI)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (11/06/25)
    - Related Jobs