• Care Review Clinician

    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 ... least 2 years experience, including experience in hospital acute care , inpatient review , prior authorization, managed ...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/23/25)
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  • Care Review Clinician

    Molina Healthcare (Detroit, MI)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... 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)
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  • Care Review Clinician

    Molina Healthcare (Sterling Heights, MI)
    …managed care , or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted in ... JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary… more
    Molina Healthcare (11/21/25)
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  • Care Review Clinician , PA…

    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 ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (11/06/25)
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  • Supervisor ( RN or Master-Level…

    Common Ground (Pontiac, MI)
    …occasionally within the community Qualifications Licensure + Active, unrestricted Michigan license as a Registered Nurse ( RN ) in the state of Michigan OR ... area emergency departments and other emergency responders, Behavioral Health Urgent Care (BHUC), and other local crisis providers. Additionally, this position will… more
    Common Ground (12/01/25)
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  • Payment Integrity Clinician

    Highmark Health (Lansing, MI)
    …of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related **SKILLS** + ... and the proper action to complete the retrospective claim review with the goal of proper and timely payment...outcomes. Will monitor and analyze the delivery of health care services in accordance with claims submitted, and analyzes… more
    Highmark Health (11/14/25)
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  • Denials Prevention Specialist, Clinician

    Datavant (Lansing, MI)
    …with clinical knowledge and expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade ... government agencies, and those who deliver and pay for care . By joining Datavant today, you're stepping onto a...by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well… more
    Datavant (11/12/25)
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  • Advanced Practice Professional (Physician…

    University of Michigan (Ann Arbor, MI)
    …accredited Nurse Practitioner program + Current licensure to practice as a Registered Nurse and Nurse Practitioner specialty certification in the State ... of Michigan + Current specialty certification to practice as an Adult-Gerontology Acute Care Nurse Practitioner + Certification as a Nurse Practitioner… more
    University of Michigan (12/02/25)
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  • Neurosurgery - Nurse Practitioner…

    Henry Ford Health System (Detroit, MI)
    …as a Certified Nurse Practitioner. Current State license as a Registered Nurse . Current BLS. Current ACLS/ATLS/PALS provider status as required by ... Henry Ford Health is seeking a skilled and experienced Nurse Practitioner (NP) or Physician Assistant (PA) for a...preferred. The ideal candidate is a motivated and adaptable clinician with a solid foundation in managing complex patients… more
    Henry Ford Health System (11/04/25)
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