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Health Insurance Case Management Jobs in Michigan

Trinity Health

Case Management

Livonia, MI · On-site

Trinity Health Livonia is a beautiful full-service, 304-bed acute care hospital, located in Livonia ... Full benefits package including Medical, Dental, Vision, PTO, Life Insurance, Short and Long-term ...

TH Medical

Director - Case Management

Detroit, MI

Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match ... Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance ...

TH Medical

Director - Case Management

Detroit, MI

Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match ... Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance ...

E3 Case Managers, LLC

Be Seen First

Nurse Case Manager

Troy, MI · On-site

$65K - $75K/yr (+ commission)

... management efforts to maximize patient recovery so they can reach their greatest level of ... Health insurance -Dental insurance -Vision insurance -Short term disability policy -Paid time off ...

New

Signing bonus

E3 Case Managers, LLC

Be Seen First

Nurse Case Manager

Troy, MI · On-site

$65K - $75K/yr (+ commission)

... management efforts to maximize patient recovery so they can reach their greatest level of ... Health insurance -Dental insurance -Vision insurance -Short term disability policy -Paid time off ...

New

Signing bonus

E3 Case Managers, LLC

Be Seen First

Nurse Case Manager

Sterling Heights, MI · On-site

$65K - $75K/yr (+ commission)

... management efforts to maximize patient recovery so they can reach their greatest level of ... Health insurance -Dental insurance -Vision insurance -Short term disability policy -Paid time off ...

New

Signing bonus

E3 Case Managers, LLC

Be Seen First

Nurse Case Manager

Sterling Heights, MI · On-site

$65K - $75K/yr (+ commission)

... management efforts to maximize patient recovery so they can reach their greatest level of ... Health insurance -Dental insurance -Vision insurance -Short term disability policy -Paid time off ...

New

Signing bonus

E3 Case Managers, LLC

Nurse Case Manager

Southfield, MI · On-site

$65K - $75K/yr (+ commission)

... management efforts to maximize patient recovery so they can reach their greatest level of ... Health insurance -Dental insurance -Vision insurance -Short term disability policy -Paid time off ...

Signing bonus

E3 Case Managers, LLC

Nurse Case Manager

Southfield, MI · On-site

$65K - $75K/yr (+ commission)

... management efforts to maximize patient recovery so they can reach their greatest level of ... Health insurance -Dental insurance -Vision insurance -Short term disability policy -Paid time off ...

Signing bonus

Henry Ford Health

Case Manager

Wyandotte, MI

$18.75 - $24/hr

... care, health insurance, and more. With 12 hospitals and hundreds of ambulatory care locations ... Certification in Case Management (CCM) by the Commission for Case Management Certification (CCMC ...

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All JobsHealth Insurance Case Management JobsHealth Insurance Case Management Jobs in Michigan

Health Insurance Case Management information

See Michigan salary details

$12

$21

$37

How much do health insurance case management jobs pay per hour?

As of Sep 13, 2026, the average hourly pay for health insurance case management in Michigan is $21.58, according to ZipRecruiter salary data. Most workers in this role earn between $16.78 and $23.46 per hour, depending on experience, location, and employer.

What is health insurance case management?

Health insurance case management is a collaborative process where a case manager helps individuals with complex health needs navigate their insurance benefits and access appropriate medical care. Case managers work with patients, healthcare providers, and insurance companies to ensure that patients receive the necessary treatments while managing costs and adhering to policy guidelines. They may assist with coordinating care, authorizing services, and providing support during treatment or recovery. The goal is to improve health outcomes and enhance the efficiency of care delivery.

How does a health insurance case manager typically collaborate with healthcare providers and policyholders?

Health Insurance Case Managers regularly serve as liaisons between policyholders, healthcare providers, and insurance companies. They coordinate care by reviewing medical records, authorizing treatments, and ensuring that care plans align with coverage policies. Effective communication and problem-solving are essential, as they often work with doctors, nurses, and social workers to advocate for the patient’s best interests while managing costs. Regular team meetings and case conferences are common, providing opportunities to discuss complex cases and develop strategies for improved outcomes.

What are the key skills and qualifications needed to thrive as a health insurance case manager, and why are they important?

To thrive as a Health Insurance Case Manager, you need a background in healthcare or nursing, familiarity with insurance regulations, and strong analytical skills, often supported by a degree in health-related fields and certifications such as CCM (Certified Case Manager). Proficiency with case management software, claims processing systems, and electronic health records is typically required. Excellent communication, problem-solving, and organizational skills help in coordinating care and advocating for patients. These competencies are crucial to ensure effective care management, compliance, and optimal outcomes for both clients and insurers.

What is the difference between Health Insurance Case Management vs Health Insurance Claims Processing?

AspectHealth Insurance Case ManagementHealth Insurance Claims Processing
CredentialsCertifications like CCM or CHCM often preferredTypically no specific certifications required
Work EnvironmentCollaborative, patient-focused, often in healthcare or insurance officesAdministrative, data entry, and review in insurance companies or claims centers
Job FocusCoordinating patient care, managing complex cases, ensuring appropriate servicesReviewing, processing, and approving insurance claims for payment

Health Insurance Case Management involves coordinating patient care and managing complex cases, often requiring specialized certifications. In contrast, Health Insurance Claims Processing focuses on administrative review and approval of claims, with less emphasis on direct patient interaction. Both roles are essential in the insurance industry but serve different functions and require different skill sets.

Health Insurance Case Management jobs near you
Infographic showing various Health Insurance Case Management job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 72% Full Time, 22% Part Time, and 5% Contract. Highlights an 92% Physical, 1% Hybrid, and 7% Remote job distribution, with an average salary of $44,882 per year, or $21.6 per hour.

Director Case Management

Detroit, MI • On-site

Veracity Ventures Inc.
See more jobs at Veracity Ventures Inc.external

Full-time

Medical, Dental, Retirement

Re-posted 19 hours ago

Job description

Benefits:
  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Relocation bonus

Director Case Management
Location: Detroit, MI
Job Type: Full-Time
Work Model: Onsite
The Director Case Management is responsible for overseeing utilization management, transition management, care coordination, compliance, and operational leadership of the hospital’s Case Management Department.
This leadership role drives hospital utilization performance improvement, denial prevention, patient throughput efficiency, regulatory compliance, and reimbursement optimization. The ideal candidate will possess strong acute hospital case management leadership experience with expertise in utilization review, payer management, care coordination, and interdisciplinary collaboration.
Work Environment
  • Hospital-based leadership role within a Level I Trauma Center
  • Fast-paced acute care environment
  • Collaboration with physicians, nursing leadership, finance, revenue cycle, ancillary teams, and executive leadership
  • Oversight of utilization management, transition planning, compliance, and care coordination
  • Data-driven operational improvement environment
Key Responsibilities
Department Operations & Leadership
  • Lead and oversee daily operations of the Case Management Department
  • Ensure effective patient throughput and reimbursement optimization
  • Maintain adequate staffing and skill mix across 7-day operations
  • Conduct staff competency evaluations and performance reviews
  • Lead departmental meetings, education sessions, and operational initiatives
Utilization Management
  • Implement and oversee the hospital Utilization Management Plan
  • Ensure accurate and timely medical necessity reviews in compliance with CMS and organizational policies
  • Monitor payer communications, authorizations, denials, and peer-to-peer review processes
  • Analyze Avoidable Days and utilization trends to drive performance improvement
  • Participate in Revenue Cycle and Medicare Performance Improvement initiatives
Transition Management & Care Coordination
  • Ensure timely transition planning assessments within 24 hours of admission
  • Monitor patient placement and discharge planning workflows
  • Support efficient sequencing of consults, procedures, and care delivery
  • Lead Complex Case Review and Patient Care Conference processes
  • Collaborate with interdisciplinary teams to optimize patient outcomes and throughput
Compliance & Regulatory Oversight
  • Ensure compliance with:
    • CMS Conditions of Participation
    • TJC Accreditation Standards
    • Federal and state regulations
    • Organizational policies
  • Implement and monitor compliance with Tenet Case Management practices
  • Support internal and external audit readiness activities
Education & Physician Engagement
  • Provide physician education regarding:
    • Medical necessity
    • Documentation accuracy
    • Regulatory compliance
    • Utilization performance
  • Educate case management staff and healthcare teams on progression of care and transition planning best practices
Must-Have Qualifications
  • Bachelor’s Degree in:
    • Nursing
    • Healthcare-related field
      OR
    • Master’s Degree in Social Work (MSW)
  • Active RN or LCSW/LMSW license
  • Minimum 3–5 years of acute hospital case management leadership experience
  • Strong experience with:
    • Utilization Management
    • Transition Management
    • Care Coordination
    • Denial Prevention
    • Patient Throughput
    • Revenue Cycle collaboration
  • Strong understanding of:
    • CMS Regulations
    • TJC Standards
    • Case Management compliance