• Registered Nurse Denial…

    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 ... and commercial insurance. 8. Educates health team colleagues about complex clinical appeals , utilization review, including role, responsibilities tools, and… more
    McLaren Health Care (10/02/25)
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  • Appeals Audit Specialist - McLaren Careers

    McLaren Health Care (Mount Clemens, MI)
    …the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer appeal/filing deadlines are met and achieve optimal ... other related duties as required and directed. **Qualifications:** **_Required:_** + Registered Health Information Technician (RHIT), Licensed Practical Nurse more
    McLaren Health Care (09/26/25)
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  • Medical Claim Review Nurse ( RN )

    Molina Healthcare (Warren, MI)
    …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 ... resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical more
    Molina Healthcare (09/06/25)
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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 (10/04/25)
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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 (08/25/25)
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  • RN Care Coordinator

    Corewell Health (Dearborn, MI)
    …experience in care management, utilization review, home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire ... criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization… more
    Corewell Health (09/23/25)
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  • Regional Manager Denial Management - McLaren…

    McLaren Health Care (Grand Blanc, MI)
    …**_Required:_** + Associate's degree in nursing or healthcare related field **.** Current Registered Nurse license in the state of Michigan or possess a ... of Medicine Degree **.** **4 years of utilization management, case management, clinical documentation, and/or denials/ appeals experience in an acute healthcare… more
    McLaren Health Care (09/26/25)
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