• Medical Review Nurse

    Molina Healthcare (Sterling Heights, MI)
    … and/or coding experience, or equivalent combination of relevant education and experience. + Registered Nurse ( RN ). License must be active and unrestricted ... 6 PM (Team will work on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Provides support for … more
    Molina Healthcare (09/06/25)
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  • RN Registered Nurse

    Henry Ford Health System (Grand Blanc, MI)
    Registered Nurse | Graduate Nurse + Sign on Bonus: $4,500 + Department: Medical ICU + Schedule: Part-Time, Nights,7pm-7:30am Weeknights &Every 3rd ... will be considered the official job description. Education/Experience Requirements + Licensed Registered Nurse credentialed from the Michigan Board of Nursing… more
    Henry Ford Health System (09/26/25)
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  • Outpatient Registered Nurse

    Fresenius Medical Center (Madison Heights, MI)
    …AND SCOPE:** Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis ... + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for… more
    Fresenius Medical Center (09/29/25)
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  • Registered Nurse Denial Appeals Lead…

    McLaren Health Care (Grand Blanc, MI)
    …, including role, responsibilities tools, and methodologies. _Required:_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from ... Three years of recent denial management, case management, clinical documentation, or utilization review experience + Five years of clinical nurse experience in… more
    McLaren Health Care (11/11/25)
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  • Registered Nurse Case Manager…

    McLaren Health Care (Pontiac, MI)
    …other related duties as required and directed. #LI-AK1 _Required_ + State licensure as a Registered Nurse ( RN ) + Bachelor's degree in nursing from accredited ... unsigned level of care (LOC) orders; communicates with utilization management nurse and obtains orders from providers. 5. Reviews current DRG/LOS identified… more
    McLaren Health Care (11/15/25)
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  • Registered Nurse - Clinical Document…

    Henry Ford Health System (Grand Blanc, MI)
    …Standard Precautions using personal protective equipment as required. Required Credential(s): + Registered Nurse credentialed from the Michigan Board of Nursing ... SUMMARY: Facilitates improvement in overall quality, completeness and accuracy of medical record documentation. Completes admission reviews and works closely with… more
    Henry Ford Health System (11/07/25)
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  • Case Manager Registered Nurse

    CVS Health (Southfield, MI)
    …status and health needs based on key questions and conversation. **Required Qualifications** - Registered Nurse with active MI state license in good standing ... all case management activities with members to evaluate the medical needs of the member to facilitate the member's...a member's overall wellness.* Uses clinical tools and information/data review to conduct an evaluation of member's needs and… more
    CVS Health (11/07/25)
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  • Clinical Nurse Manager / RN

    AccentCare, Inc. (Madison Heights, MI)
    Overview Registered Nurse / RN Team Director , Hospice Location: Madison Heights, MI Position: Registered Nurse / RN Team Director Job ID: ... Find Your Passion and Purpose as a Full-Time Hospice Registered Nurse / RN Team...+ Three+ years' experience in hospice, home health, general medical surgery, oncology, or patient population-specific nursing (ie, geriatrics,… more
    AccentCare, Inc. (09/18/25)
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  • RN UM Clinical Appeals Nurse Remote

    Molina Healthcare (Sterling Heights, 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...specific programs supported by the plan such as utilization review , medical claims review , long-term… more
    Molina Healthcare (11/14/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Sterling Heights, 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 ... a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
    Molina Healthcare (11/01/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Sterling Heights, MI)
    For this position we are seeking a ( RN ) Registered Nurse who must be licensed for the state they reside This role will be doing Utilization review for ... authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted… more
    Molina Healthcare (11/13/25)
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  • RN UM Care Review Clinician Remote

    Molina Healthcare (Sterling Heights, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The RN Care Review Clinician provides support...care unit, or in a telemetry type setting. UM medical review experience highly preferred. Work Hours:… more
    Molina Healthcare (11/13/25)
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  • RN Care Review Clinician Remote

    Molina Healthcare (Sterling Heights, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION **Job Summary** The Care Review Clinician ( RN ) provides support for...requests within required timelines. * Refers appropriate cases to medical directors (MDs) and presents them in a consistent… more
    Molina Healthcare (11/13/25)
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  • Care Review Clinician, PA ( RN )

    Molina Healthcare (Sterling Heights, MI)
    …for internal meetings. **JOB QUALIFICATIONS** **Required Education** Completion of an accredited Registered Nurse ( RN ). **Required Experience** 1-3 years of ... clinic experience. **Required License, Certification, Association** Active, unrestricted State Registered Nursing ( RN ) license in good standing. **Preferred… more
    Molina Healthcare (11/06/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Sterling Heights, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
    Molina Healthcare (11/13/25)
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  • Care Review Clinician ( RN )

    Molina Healthcare (Sterling Heights, MI)
    …authorization, managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
    Molina Healthcare (11/13/25)
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  • * RN Coordinator-Utilization Review

    Henry Ford Health System (Warren, MI)
    …screening criteria and critical thinking to maximize reimbursement. EDUCATION/EXPERIENCE REQUIRED: + Registered Nurse required. + Minimum 3-5 years of clinical ... experience in lieu of bachelor's degree. CERTIFICATIONS/LICENSURES REQUIRED: + Registered Nurse with a valid, unrestricted State...Ford is one of the nation's most respected academic medical centers and is leading the Future of Health:… more
    Henry Ford Health System (09/25/25)
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  • RN Care Coordinator

    Corewell Health (Royal Oak, MI)
    …in care management, utilization review , home care and/or discharge planning. Preferred + Registered Nurse ( RN ) - State of Michigan License Upon Hire ... for patients utilizing hospital outpatient, observation or inpatient services. 4. May review cases for medical necessity, uses InterQual and/or other UR/UM… more
    Corewell Health (11/04/25)
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  • RN PreOp PACU II - Michigan Endoscopy…

    Surgery Care Affiliates (Novi, MI)
    …change. If you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse ( RN ) PreOp PACU. + Promote the mission, vision, and ... your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company...to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing… more
    Surgery Care Affiliates (10/10/25)
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  • Licensed Practical Nurse LPN Ambulatory…

    Henry Ford Health System (Novi, MI)
    …preferred. Strong IV skills a must. GENERAL SUMMARY: Under the delegated authority of a registered nurse or provider, the Licensed Practical Nurse (LPN) uses ... Licensed Practical Nurse LPN - Ambulatory Gastroenterology - Novi Location...items, cleaning rooms, in-basket, medication refills under standing order, review prep instructions w/patients, etc. Will rotate between colon… more
    Henry Ford Health System (10/30/25)
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