• RN Medical Review Nurse Remote

    Molina Healthcare (Grand Rapids, MI)
    …and supports ( LTSS ) issues. + Identifies and reports quality of care issues. + Assists with complex claim review including diagnosis-related group (DRG) ... Contributes to overarching strategy to provide quality and cost-effective member care . This position will be supporting our Appeals and Grievances department.… more
    Molina Healthcare (12/03/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (MI)
    …services and supports ( LTSS ) issues. * Identifies and reports quality of care issues. * Prepares and presents cases in conjunction with the chief medical officer ... guidelines. Assesses appropriateness of services, length of stay and level of care provided to members. Contributes to overarching strategy to provide quality and… more
    Molina Healthcare (11/14/25)
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