• Clinical Appeals Nurse

    Molina Healthcare (Detroit, MI)
    … decisions for appeals outcomes within compliance standards. **KNOWLEDGE/SKILLS/ABILITIES** + The Clinical Appeals Nurse ( RN ) performs clinical ... **JOB DESCRIPTION** For this position we are seeking a ( RN ) Registered Nurse who must...with internet connectivity of high speed required **Job Summary** Clinical Appeals is responsible for making appropriate… more
    Molina Healthcare (08/02/25)
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  • Registered Nurse or Physical…

    CenterWell (Lansing, MI)
    …or requested. **Use your skills to make an impact** **Required Experience/Skills:** + Registered Nurse or Physical Therapist. + Current state license as a ... and monitoring all payer requests for additional documentation (ADR), appeals and denials. Works with branch staff to gather... Registered Nurse or Physical Therapist. + 5… more
    CenterWell (07/30/25)
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  • Clinical Manager - Provider Appeals

    Henry Ford Health System (Troy, MI)
    Clinical Director, Appeals and Grievance. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse with current Michigan licensure + Bachelor's Degree in ... GENERAL SUMMARY: The Clinical Manager, Provider Appeals supports appeals team members to plan, direct, evaluate, coordinate, and manage the activities… more
    Henry Ford Health System (08/02/25)
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  • Clinical Appeals Supervisor

    R1 RCM (Detroit, MI)
    …sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Supervisor** , you will help support clinicians ... position. **Here's what you will experience working as a Clinical Appeals Supervisor:** + Track and monitor...for additional support and engagement. **Required Skills:** + Active Registered Nurse license For this US-based position,… more
    R1 RCM (07/18/25)
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  • RN Utilization Management Coordinator PRN

    Corewell Health (Southfield, MI)
    …of relevant experience 2 years of experience in clinical /hospital setting. Required + Registered Nurse ( RN ) - State of Michigan Upon Hire required How ... and procedure and payer requests. + Routinely collaborates with the System Clinical Appeals and Revenue Cycle departments to expedite billing and appeals more
    Corewell Health (07/31/25)
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  • Infusion Referral Nurse - REMOTE

    Prime Therapeutics (Lansing, MI)
    …visa or residency sponsorship. **Additional Qualifications** + Registered Nurse ( RN ). + 5 years of post-degree clinical experience. + Experience in ... these cases in web-based application and spreadsheets. + Supports clinical services such as the appeals program....+ Associates - Nursing + Bachelors - Nursing + RN - Registered Nurse , State… more
    Prime Therapeutics (07/24/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon ... criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization… more
    Corewell Health (06/27/25)
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  • Departmental Specialist 13 - Specialized Nursing…

    State of Michigan (Lansing, MI)
    …Psychologist (LLP); Fully Licensed Psychologist (LP); Licensed Master Social Worker (LMSW); Registered Nurse ( RN ); Licensed Professional Counselor (LPC) + ... Inclusion . Reviews, coordinates and represents the Department on statewide appeals of preadmission screenings/annual resident reviews Medicaid recoveries before the… more
    State of Michigan (08/01/25)
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