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Manager Utilization Management Jobs in Michigan (NOW HIRING)

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

Corewell Health

Utilization Mgmt Spec

Climax, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

CVS Health

MI · On-site

$29.10 - $62.32/hr

Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. UM Nurse Consultant Fully Remote- WFH Schedule : Monday-Friday 10:30AM- 7:30PM Position ...

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Manager Utilization Management information

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

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a manager utilization management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a manager utilization management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.

What are the most commonly searched types of Utilization Management jobs in Michigan?

The most popular types of Utilization Management jobs in Michigan are:

What are popular job titles related to Manager Utilization Management jobs in Michigan?

For Manager Utilization Management jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Manager Utilization Management jobs in Michigan look for?

The top searched job categories for Manager Utilization Management jobs in Michigan are:

What cities in Michigan are hiring for Manager Utilization Management jobs?

Cities in Michigan with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 1% Temporary, and 4% Contract. Highlights an 91% Physical, 4% Hybrid, and 5% Remote job distribution.

UTILIZATION MANAGEMENT CLINICIAN

Muskegon County

Muskegon, MI • On-site

Other

Posted 3 days ago

New

Job description

Utilization Management/Utilization Review Tasks

An employee in this class, under general direction, performs Utilization Management/Utilization Review tasks to ensure delivery of medically necessary services related to mental health, substance use disorder, and/or intellectual/developmentally disabled consumers. These services will be at the correct frequency and duration to meet consumer goals and alleviate symptoms.

Required Minimum Entrance Qualifications

1. Must hold a master's degree from an accredited college or university with a major in Social Work, Clinical Psychology, Counseling, Marriage and Family Therapy or closely related field AND be fully licensed by the State of Michigan in their relevant field within 90 days of hire. 2. Have one (1) year of previous experience working with persons with developmental disabilities, mental illness and/or serious emotional disturbance; please note, internships count as work experience if they are documented in the Work Experience section of the employment application. 3. Must have reliable transportation that may have to be used to carry out job duties of this classification. Preferred but not Required 1. Be certified as a CADC, CAADC, or be on a Development Plan with MCBAP. 2. Bilingual candidates highly desired. 3. Lived experiences with mental illness/developmental disabilities/substance use disorders valued. 4. Individuals in Recovery and individuals with experience in Armed Services valued.

Physical Conditions / Work Location

PHYSICAL ACTIVITIES An employee in this class generally performs sedentary work requiring the occasional lifting of objects weighing thirty-five (35) pounds or less. ENVIRONMENTAL CONDITIONS A Utilization Management Clinician generally works at the various HealthWest program locations; however, travel to locations within the County may be required.

Additional Information

The purpose of this recruitment is to establish an eligible list from which to fill present and future vacancies in this classification in the County system. For each opening, the Department Head has her/his choice of the candidates who meet the required minimum entrance qualifications. This list remains in effect for three months unless exhausted or extended.

MUSKEON COUNTY IS AN EQUAL OPPORTUNITY EMPLOYER MUSKEGON COUNTY HAS ADOPTED A VETERANS PREFERENCE POLICY THAT RECOGNIZES QUALIFYING MILITARY SERVICE

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