• RN UM Clinical Appeals…

    Molina Healthcare (MI)
    **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal appeals clinical processes - ensuring that ... to provide quality and cost-effective member care. Candidates with UM and Appeals experience are highly preferred...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/14/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Detroit, 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 ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review,...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Ann Arbor, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... Summary** The RN Care Review Clinician provides support for clinical member services review assessment processes. Responsible for verifying that services are… more
    Molina Healthcare (11/09/25)
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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 (11/04/25)
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  • RN Utilization Management Referral…

    Corewell Health (Grand Rapids, MI)
    … clinical nursing and or case management/managed care or related field Preferred + Registered Nurse ( RN ) - State of Michigan Upon Hire required + ... waiting list, insurance prior authorizations, continuous stay reviews and appeals . Additional support to the UM functions...within 7 years for those who start in this RN role on or after January 1, 2017 (Spectrum… more
    Corewell Health (11/04/25)
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  • RN Case Manager: University Hospital (Care…

    University of Michigan (Ann Arbor, MI)
    RN CASE MANAGER: University Hospital (Care Management) Apply Now **Job Summary** The RN Case Manager assesses, develops, implements, coordinates and monitors a ... care areas. The position is unique in that it combines clinical /quality considerations with regulatory/financial/utilization review demands. The position creates a… more
    University of Michigan (11/12/25)
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