• RN Utilization Review…

    Corewell Health (Caledonia, MI)
    …acute care, clinical nursing, preferably multiple clinical settings, or related experience Required + Registered Nurse ( RN ) - State of Michigan required How ... Must live in MICHIGAN and have MICHIGAN RN LICENSE Scope of Work: Provides health information, interacts and acts as a resource for nursing units for complex… more
    Corewell Health (12/02/25)
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  • Healthcare Clinical Documentation…

    Deloitte (Detroit, MI)
    …degree, or physician assistant required + Current Registered Nurse ( RN ) license required + Certified Clinical Documentation Specialist - CCDS (inpatient) ... registered nurse , physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN , Quality,… more
    Deloitte (11/21/25)
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  • Denials Prevention Specialist , Clinician…

    Datavant (Lansing, MI)
    …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers +… more
    Datavant (11/12/25)
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  • Organizational Quality Nurse…

    Hospice of Michigan (Southfield, MI)
    …CARE Model of Service: courtesy, acknowledgement, response and empathy. Qualifications: + Registered Nurse with a baccalaureate degree in nursing, preferably a ... work with minimal supervision. + Requires knowledge of quality assessment and utilization review functions, principles and practices. + Theoretical and practical… more
    Hospice of Michigan (10/03/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (MI)
    …health, pharmacy, etc.), or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... **JOB DESCRIPTION** **Job Summary** The Clinical Appeals Nurse ( RN ) provides support for internal...the specific programs supported by the plan such as utilization review , medical claims review ,… more
    Molina Healthcare (11/14/25)
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  • Supervisor, Clinical Documentation Integrity (CDI)…

    Trinity Health (Livonia, MI)
    …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... within their region. Provides direct oversight of the Clinical Documentation Specialist and Clinical Documentation Integrity Coordinator. Working with the Regional… more
    Trinity Health (11/24/25)
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