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 ...
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 ...
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 ...
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 ...
Required * Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire ...
Required * Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire ...
Required * Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire ...
Required * Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire ...
Utilization Management Clinical Analyst HYBRID (PCN 1534)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness of behavioral health ...
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Utilization Management Clinical Analyst HYBRID (PCN 1534)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness of behavioral health ...
Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of substance use disorder authorization requests to determine ...
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Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of substance use disorder authorization requests to determine ...
Director of Utilization Management (PCN 1527)
Troy, MI · On-site
$102K - $128K/yr
Provides supervision for the manager of UM * Leads the Utilization Management Committee. * Analyzes utilization data; makes improvements; provides training /education, as needed; and ensures that the ...
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Director of Utilization Management (PCN 1527)
Troy, MI · On-site
$102K - $128K/yr
Provides supervision for the manager of UM * Leads the Utilization Management Committee. * Analyzes utilization data; makes improvements; provides training /education, as needed; and ensures that the ...
New
Senior Utilization Management Compliance and Accreditation Specialist Number of Positions: 1 Location: Detroit, MI Location Specifics: Hybrid Position Job Summary: At Delta Dental of Michigan, Ohio ...
Senior Utilization Management Compliance and Accreditation Specialist Number of Positions: 1 Location: Detroit, MI Location Specifics: Hybrid Position Job Summary: At Delta Dental of Michigan, Ohio ...
Utilization Review Nurse
Troy, MI · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Utilization Review Nurse
Troy, MI · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
RN Utilization Review Nurse
$33 - $37/hr
Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. * Works with the Utilization Management team primarily responsible for inpatient medical necessity ...
RN Utilization Review Nurse
$33 - $37/hr
Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare. * Works with the Utilization Management team primarily responsible for inpatient medical necessity ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction.
Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction.
Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... Role Summary Advise clients on network strategy, utilization performance, and provider market ...
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Underpinned by technology, data, analytics, AI, change management, talent and sustainability ... Role Summary Advise clients on network strategy, utilization performance, and provider market ...
New
Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction.
Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction.
Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction.
Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction.
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region. Position Overview The Physician Advisor ...
Utilization Review Supervisor (PCN 1547)
Troy, MI · On-site
$70K - $87K/yr
The position also participates in management meetings, workgroups, and strategic initiatives while ... Supervise and evaluate Utilization Review (UR) and Acute Care Authorization staff to ensure ...
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Utilization Review Supervisor (PCN 1547)
Troy, MI · On-site
$70K - $87K/yr
The position also participates in management meetings, workgroups, and strategic initiatives while ... Supervise and evaluate Utilization Review (UR) and Acute Care Authorization staff to ensure ...
Manager Utilization Management information
See Detroit, MI salary details
$38.6K - $50.2K
9% of jobs
$58.7K is the 25th percentile. Wages below this are outliers.
$50.2K - $61.7K
22% of jobs
$61.7K - $73.3K
11% of jobs
The median wage is $80.4K / yr.
$73.3K - $84.9K
14% of jobs
$84.9K - $96.4K
12% of jobs
$103.7K is the 75th percentile. Wages above this are outliers.
$96.4K - $108K
13% of jobs
$108K - $119.6K
13% of jobs
$119.6K - $131.1K
5% of jobs
$131.1K - $142.7K
2% of jobs
$142.7K - $154.3K
0% of jobs
$154.3K - $165.8K
0% of jobs
$38.6K
$90.1K
$165.8K
How much do manager utilization management jobs pay per year?
What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?
What is the difference between Manager Utilization Management vs Utilization Review Nurse?
| Aspect | Manager Utilization Management | Utilization Review Nurse |
|---|---|---|
| Credentials | RN, often with management or utilization review certifications | RN, with certifications in utilization review or case management |
| Work Environment | Supervises teams, manages policies, oversees utilization review processes | Performs patient chart reviews, assesses medical necessity, collaborates with providers |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Hospitals, insurance companies, healthcare organizations |
| Search & Comparison Intent | Yes | Yes |
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 in Utilization Management, and how can they effectively address them?
What does a Manager of Utilization Management do?
- Registered Nurse Case Management
- Part Time Remote Utilization Review Nurse
- Weekend Physician Advisor Utilization Review
- Online Health Information Management Faculty
- Temporary Admission Discharge Nurse
- Remote Cvs Utilization Management Nurse
- Nurse Case Management
- Rn Case Management No Experience
- Registered Nurse Utilization Review

Part-time
Medical, Vision, Retirement
Posted 13 days ago
Corewell Health rating
6.9
Based on 771 frontline employees who took The Breakroom Quiz
456th of 890 rated healthcare providers
Job description
Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.
Essential Functions
- Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.
- 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 outpatient or inpatient status.
- Utilizes electronic medical record work queues that support Utilization Management functions.
- Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
- Problem solves issues that are received via phone, fax or email.
- Other duties as assigned.
Qualifications
Required
- High School Diploma or equivalent
Preferred
- 2 years of relevant experience healthcare experience
- Preferred Post high school training and/or academic coursework leading toward associate's or bachelor's degree.
About Corewell Health
As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.
How Corewell Health cares for you
- Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
- On-demand pay program powered by Payactiv
- Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
- Optional identity theft protection, home and auto insurance
- Traditional and Roth retirement options with service contribution and match savings
- Eligibility for benefits is determined by employment type and status
Primary Location
SITE - Corewell Health Southfield Center - 26901 Beaumont Blvd
Department Name
Utilization Management - Diversified East WB Mkt
Employment Type
Part time
Shift
Day (United States of America)
Weekly Scheduled Hours
8
Hours of Work
8:00 a.m. - 4:30 p.m.
Days Worked
Monday - Friday
Weekend Frequency
N/A
CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
What Corewell Health employees say
Pay
Benefits
Hours and flexibility
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About Corewell Health
Sourced by ZipRecruiter
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Grand Rapids, MI, US