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Insurance Utilization Review Jobs in Michigan (NOW HIRING)

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

... Insurance and much more! More information is available on our Benefits Guest Website: benefits ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

... Insurance and much more! More information is available on our Benefits Guest Website: benefits ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...

UHS

Utilization Review Manager

Grand Rapids, MI

... Insurance and much more! More information is available on our Benefits Guest Website: benefits ... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ...

UHS

UR COORDINATOR

Augusta, MI · On-site

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

UHS

UR COORDINATOR

Augusta, MI

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

UHS

UR COORDINATOR

Augusta, MI

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

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How much do insurance utilization review jobs pay per hour?

As of Jul 28, 2026, the average hourly pay for insurance utilization review in Michigan is $36.85, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $42.31 per hour, depending on experience, location, and employer.

What are the most common challenges faced by Insurance Utilization Review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

What are the key skills and qualifications needed to thrive in the Insurance Utilization Review position, and why are they important?

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an Insurance Utilization Review job?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Michigan? The most popular types of Insurance Utilization Review jobs in Michigan are:
What are popular job titles related to Insurance Utilization Review jobs in Michigan? For Insurance Utilization Review jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Michigan look for? The top searched job categories for Insurance Utilization Review jobs in Michigan are:
What cities in Michigan are hiring for Insurance Utilization Review jobs? Cities in Michigan with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Michigan as of July 2026, with employment types broken down into 1% As Needed, 72% Full Time, 21% Part Time, 5% Contract, and 1% Nights. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $76,654 per year, or $36.9 per hour.
Utilization Review Specialist (Remote)

Utilization Review Specialist (Remote)

Coronis Health

Jackson, MI • On-site

$60K - $62K/yr

Full-time, Part-time

Posted 5 days ago

Coronis Health rating

7.7

Company rating: 7.7 out of 10

Based on 9 frontline employees who took The Breakroom Quiz

168th of 488 rated business services

Job description

Title: Utilization Review Specialist/Behavioral Health Substance Abuse (Remote)
Reports to: UR Manager
FLSA Classification: Exempt
Full-Time or Part-Time: Full-Time
Salary Range: $60,000 to $62,000
Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise.

Position Overview:
The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies. The role involves providing appropriate client information to third-party payers regarding the medical necessity of treatment in a timely manner. The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews, and appeal reviews as needed.

Key Responsibilities:

  1. Act as the agency liaison with insurance and managed care companies for the authorization of treatment costs, representing the company in a positive and professional manner.
  2. Participate in staff meetings as needed.
  3. Ensure clear communication with supervisors, co-workers, and facilities.
  4. Keep abreast of changes and monitor compliance with State and Federal laws and regulations in areas of insurance and third-party payers.
  5. Protect the confidentiality of patients and the privacy of staff.
  6. Use a computer to type correspondence, reports, and other items as requested, ensuring accuracy.
  7. Process data in conjunction with a compliance consultant to present it effectively using established statistical methods.
  8. Demonstrate the willingness to accept responsibility.
  9. Perform other duties as assigned by the Director of Utilization Review.

Qualifications:

Minimum Education/Certifications/OTJ Experience:

  • BA in Psychology or a related field.
  • Three to five (5) years of experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, Case Manager, or Utilization Review Coordinator).

Knowledge of Subject Matter:

  • Prior Utilization Review experience in a Substance Abuse environment is mandatory.
  • Knowledge of ASAM guidelines.
  • Knowledge of medical terminology.
  • Knowledge of State and Federal Statutes regarding patient confidentiality laws.
  • Knowledge of Drug-Free Workplace Policies, Corporate Integrity, and Compliance Programs.
  • Knowledge of state guidelines and accreditation agency standards.

Skills:

  • Ability to establish rapport and supervise employees and professional staff.
  • Ability to work under stressful conditions and be flexible in relation to department needs.
  • Demonstrates proficiency in verbal and written communication skills.
  • KIPU experience required; Best Notes experience is a plus.

Abilities/Attributes:

  • Demonstrates willingness to accept responsibility and perform tasks with minimal supervision.

Additional Information:
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.
Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal-opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all backgrounds.


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