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Healthcare Management Healthcare Administration

RN Clinical Claims Review – Utilization & Appeals

Job in Detroit, Wayne County, Michigan, 48228, USA
Listing for: Molina Healthcare
Full Time position
Listed on 2026-02-02
Job specializations:
  • Healthcare
    Healthcare Management, Healthcare Administration
Salary/Wage Range or Industry Benchmark: 60000 - 80000 USD Yearly USD 60000.00 80000.00 YEAR
Job Description & How to Apply Below
A healthcare provider in Detroit is seeking a Clinical Nurse to support medical claim reviews and appeals, ensuring compliance with state and federal regulations. The ideal candidate will have at least 2 years of clinical nursing experience, including utilization review, and must hold an active RN license. Responsibilities include facilitating clinical reviews, validating claims, and resolving complaints. A competitive benefits package is offered, with an hourly pay range of $29.05 - $67.97.
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