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Director Of Utilization Management Jobs in Michigan

Integra Partners

Director of Utilization Management

Troy, MI · On-site +1

$160K - $160K/yr

KNOWLEDGE/SKILLS/ABILITIES The Director of Utilization Management's responsibilities include but are not limited to: * Prepare and maintain Utilization Review Plan policies and procedures * Obtain or ...

UHS

Manager of Utilization Review

Saint Johns, MI

This includes the implementation of case management scenarios, consulting with all services to ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...

UHS

Manager of Utilization Review

Saint Johns, MI · On-site

This includes the implementation of case management scenarios, consulting with all services to ... 5 years direct clinical experience in a psychiatric or mental health treatment setting. EEO ...

UHS

Manager of Utilization Review

Saint Johns, MI

This includes the implementation of case management scenarios, consulting with all services to ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...

UHS

Manager of Utilization Review

Saint Johns, MI

This includes the implementation of case management scenarios, consulting with all services to ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...

UHS

Manager of Utilization Review

Saint Johns, MI · On-site

This includes the implementation of case management scenarios, consulting with all services to ... Requirements LMSW, LPC, RN or LVN licensure in the state of Michigan required. 3-5 years direct ...

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All JobsOf Utilization Management JobsDirector Of Utilization Management JobsDirector Of Utilization Management Jobs in Michigan

Director Of Utilization Management information

See Michigan salary details

$15.7K

$45.6K

$73.2K

How much do director of utilization management jobs pay per year?

As of Aug 26, 2026, the average yearly pay for director of utilization management in Michigan is $45,603.00, according to ZipRecruiter salary data. Most workers in this role earn between $34,900.00 and $52,300.00 per year, depending on experience, location, and employer.

What does a director of utilization management do?

A Director of Utilization Management oversees the processes that ensure patients receive appropriate, efficient, and medically necessary care within a healthcare organization. They lead teams that review patient cases, manage resource use, and implement policies to optimize healthcare quality and cost-effectiveness. This role often involves coordinating with physicians, insurance providers, and other healthcare professionals to ensure compliance with regulatory standards and best practices. Their goal is to balance patient care needs with organizational efficiency, ultimately improving patient outcomes and reducing unnecessary expenses.

What are the key skills and qualifications needed to thrive as a director of utilization management?

To thrive as a Director of Utilization Management, you typically need a strong background in healthcare administration, case management, and managed care principles, often supported by a clinical degree (RN, LCSW, or equivalent) and relevant experience. Familiarity with utilization review software, health information systems, and certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) are highly valued. Leadership, strategic decision-making, and excellent interpersonal skills help drive team performance and facilitate collaboration across departments. These competencies are vital to ensuring effective resource use, regulatory compliance, and high-quality patient outcomes.

What are some common challenges faced by a director of utilization management and how can they be addressed?

A Director of Utilization Management often navigates challenges such as balancing cost containment with quality patient care, managing interdisciplinary teams, and keeping up with changing healthcare regulations. Successfully addressing these challenges requires strong communication skills, the ability to analyze and implement evidence-based utilization protocols, and fostering a collaborative environment among clinical staff, case managers, and administrative teams. Staying engaged with ongoing education and industry best practices also helps in proactively adapting to regulatory updates and evolving patient needs.

What is the difference between Director Of Utilization Management vs Utilization Review Nurse?

AspectDirector Of Utilization ManagementUtilization Review Nurse
CredentialsTypically requires a nursing license, healthcare management experience, and sometimes a master's degreeRegistered Nurse (RN) license, often with certifications in case management or utilization review
Work EnvironmentAdministrative setting, overseeing utilization management teams and policiesClinical setting, performing patient chart reviews and assessments
Employer & IndustryHospitals, insurance companies, healthcare systemsHospitals, insurance companies, healthcare providers
Primary FocusStrategic oversight of utilization management processes and complianceClinical review of patient cases to determine medical necessity

The main difference is that the Director Of Utilization Management focuses on overseeing and managing utilization strategies at an organizational level, while the Utilization Review Nurse conducts clinical reviews to assess individual patient cases. Both roles require healthcare credentials, but their responsibilities and work environments differ significantly.

What cities in Michigan are hiring for Director Of Utilization Management jobs?

Cities in Michigan with the most Director Of Utilization Management job openings:

Director Of Utilization Management jobs near you
Infographic showing various Director Of Utilization Management job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 14% Part Time, 2% Temporary, 3% Contract, and 1% Nights. Highlights an 84% Physical, 3% Hybrid, and 13% Remote job distribution, with an average salary of $45,603 per year, or $21.9 per hour.

Director of Utilization Management

Troy, MI • On-site, Remote

Integra Partners
Health Care and Social Assistance • 201 - 500 employees
Learn more about Integra Partnersexternal

$160K - $160K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Job description

Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This individual will play a key role in delivering UM to our health plan clients, growing our UM business, and working with the organization to operationalize our UM program.
JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES
The Director of Utilization Management's responsibilities include but are not limited to:
  • Prepare and maintain Utilization Review Plan policies and procedures
  • Obtain or maintain certification or license in states when performing Utilization Review
  • Work with Chief Medical Director to establish, adopt, and review UM benefit and medical necessity decision-making criteria
  • Manage UM Department, clinical and non-clinical staff, to ensure timely review of prior authorizations and appeals
  • Responsible for UM-related quality improvement activities, including conducting audits to ensure consistent application of medical criteria, evaluating program for improvement opportunities and annual IRR testing
  • Communicate and work with company executives and management to ensure alignment of UM program with departments and corporate initiatives
  • Participate on Quality Improvement Committee and UM Committee to oversee clinical oversight of UM Department
  • Work in conjunction with Account Managers and external liaison for clients to ensure program meets contractual delegated activities and performance requirements
  • As needed, represent the UM team in support of client-facing efforts such as business development and/or business review activities.
  • Help consult on existing and/or prospective client UM programs
  • Participate in technology related activities and implement solutions across UM Department
  • Oversee and execute the workplan to maintain NCQA certification
  • Build and manage the administrative and clinical resources to ensure the UR program functions efficiently and effectively, meeting all internal, legal, regulatory, and/or certification standards
  • Build and maintain a staffing model that is flexible and appropriate to scale as the business scales
  • Manage internal policies and procedures and workflows to ensure compliance, effectiveness, and best in class clinical operations
  • Owner of the third party technology and configuration of medical management software to ensure optimal operation
  • Responsible for day-to-day team management to ensure on-time, on-budget delivery of all operations • As needed, represent the UM team in support of client-facing efforts such as business development and/or business review activities
  • Help consult on existing and/or prospective client UM programs

WHAT WILL YOU LEARN IN THE FIRST 6 MONTHS?
  • In the first six months you will learn the function of the UM department within the organization and be fully integrated in your position, company, and team
  • You will have a full and complete understanding of our metric requirements and reporting capabilities
  • You will understand your role and responsibilities, to foster excellence in team performance
  • You will develop team goals and monitor progress, as you build relationships with your team to encourage and understand their needs and abilities
  • During this time, you will set measurable goals for personal development and growth

WHAT WILL YOU ACHIEVE IN THE FIRST 12 MONTHS?
  • You will create a people first approach to your team, easily identifying the strengths and weakness of each team member and how to best support them
  • You will be contributing your skills and knowledge to meet your department's metrics and goals

EXPERIENCE:
  • Bachelor's degree in area of specialty, preferred
  • Minimum of 10 years of UM management experience in a managed care setting
  • Experience with UM NCQA or URAC certification/accreditation
  • Experience with leading and managing teams of clinical and non-clinical staff
  • Analytical ability and clinical knowledge in order to assess medical records, identify trends, and report findings
  • Communication skills, verbal and written, needed to convey information clearly and consistently
  • Interpersonal skills necessary to develop and maintain a wide variety of cooperative working relationships

Salary: $160,000.00/Annually
Benefits Offered
  • Competitive compensation and annual bonus program
  • 401(k) retirement program with company match
  • Company-paid life insurance
  • Company-paid short term disability coverage (location restrictions may apply)
  • Medical, Vision, and Dental benefits
  • Paid Time Off (PTO)
  • Paid Parental Leave
  • Sick Time
  • Paid company holidays and floating holidays
  • Quarterly company-sponsored events
  • Health and wellness programs
  • Career development opportunities

Remote Opportunities
We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.
Our Story
Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.
With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We're looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.
Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don't hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

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