• 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 with… more
    CVS Health (09/24/25)
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  • * 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)
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  • RN , Manager, Utilization Management…

    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 role. +… more
    Humana (09/28/25)
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  • Medical Claim Review Nurse

    Molina Healthcare (Warren, MI)
    …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... hours 6 AM to 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing… more
    Molina Healthcare (09/06/25)
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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 ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual… more
    Molina Healthcare (09/05/25)
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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) ... medical clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ), Licensed Vocational Nurse more
    Molina Healthcare (09/18/25)
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  • Registered Nurse Denial Appeals…

    McLaren Health Care (Grand Blanc, MI)
    …related duties as required and directed. **Qualifications:** _Required_ + State licensure as a registered nurse ( RN ) + Bachelor's degree in nursing from ... + Three years of recent case management, clinical documentation, or utilization review experience + Five years of clinical nurse experience in an acute… more
    McLaren Health Care (09/30/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... patients. + Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). +… more
    Corewell Health (09/23/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire required ... patients. 1. Identifies patients that need care management services (ie utilization review ; care coordination; and/or discharge/transition planning). 2.… more
    Corewell Health (08/25/25)
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  • Registered Nurse Case Manager…

    Henry Ford Health System (Detroit, MI)
    …community partners to support patient needs beyond the hospital setting. Qualifications: + Registered Nurse ( RN ) with active licensure + Minimum [number] ... and the ability to work in a fast-paced environment. Licenses and Certifications: + Registered Nurse ( RN ) with a valid, unrestricted State of Michigan… more
    Henry Ford Health System (07/10/25)
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