• Registered Nurse - Clinical…

    Cognizant (Lansing, MI)
    …need to have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...clinic operations . Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial and… more
    Cognizant (10/09/25)
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  • Registered Nurse Denial…

    McLaren Health Care (Grand Blanc, MI)
    …and commercial insurance. 8. Educates health team colleagues about complex clinical appeals , utilization review, including role, responsibilities tools, and ... duties as required and directed. **Qualifications:** _Required_ + State licensure as a registered nurse (RN) + Bachelor's degree in nursing from accredited… more
    McLaren Health Care (10/02/25)
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  • Appeals Audit Specialist - McLaren Careers

    McLaren Health Care (Mount Clemens, MI)
    …outcomes and fulfills the obligation and responsibilities of the role to support the clinical team. 3. Collaborates with the Denials Appeals RN to ensure payer ... 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)
    …resource for Utilization Management, Chief Medical Officers, Physicians, and Member/Provider Inquiries/ Appeals . + Provides training and support to clinical ... (Team will work on set schedule) Looking for a RN with experience with appeals , claims review, and medical coding. **Job Summary** Utilizing clinical knowledge… more
    Molina Healthcare (09/06/25)
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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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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization ... Level II pediatric trauma designations. The advanced capabilities and clinical expertise within this center have earned it Magnet...utilization review, home care and/or discharge planning. Preferred + Registered Nurse (RN) - State of Michigan… more
    Corewell Health (08/25/25)
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  • RN Care Coordinator

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