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Manager Utilization Management Jobs in Detroit, MI

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Remote Utilization Review RN

Detroit, MI · Remote

$35 - $39/hr

  • Medical

  • Dental

  • Vision

  • PTO

Minimum 5 years of healthcare experience . * 3-5 years of Utilization Management experience required. * Experience with InterQual and/or MCG criteria . * Knowledge of CMS, NCQA, HIPAA, PA60 ...

Veracity Ventures Inc.

Director Case Management

Detroit, MI · On-site

$120 - $160/hr

  • Medical

  • Dental

  • Retirement

Onsite The Director Case Management is responsible for overseeing utilization management, transition management, care coordination, compliance, and operational leadership of the hospital's Case ...

Veracity Ventures Inc.

Director Case Management

Detroit, MI · On-site

  • Medical

  • Dental

  • Retirement

Onsite The Director Case Management is responsible for overseeing utilization management, transition management, care coordination, compliance, and operational leadership of the hospital's Case ...

Epitec

Registered Nurse-Review Analys

Detroit, MI · On-site

  • Medical

The ideal candidate will have a strong background in Care Management, Utilization Management, InterQual/MCG criteria, clinical training, and quality improvement . Responsibilities * Educate staff on ...

Ambition 24Hours Inc

Director Case Management

Detroit, MI · On-site

$103K - $155K/yr

Lead utilization management and medical necessity review processes * Ensure compliance with CMS regulations and Joint Commission standards * Manage patient transition planning and discharge ...

Corewell Health

RN Care Coordinator

Wayne, MI · On-site

  • Medical

  • Retirement

Utilization Management Coordinator Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and ...

Corewell Health

RN Care Coordinator

Northville, MI · On-site

Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning). Responsible for managing a case load of patients that ...

Integra Partners

Utilization Management Nurse - LPN/LVN

Troy, MI · Remote

$60K - $60K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Integra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key ...

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Corewell Health

RN Care Coordinator

Royal Oak, MI · On-site

  • Medical

  • Retirement

Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning). * Responsible for managing a case load of patients that ...

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Showing results 21-40

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Detroit, MI

Manager Utilization Management information

See Detroit, MI salary details

$38.6K

$90.1K

$165.8K

How much do manager utilization management jobs pay per year?

As of Aug 20, 2026, the average yearly pay for manager utilization management in Detroit, MI is $90,098.00, according to ZipRecruiter salary data. Most workers in this role earn between $58,900.00 and $108,400.00 per year, depending on experience, location, and employer.

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 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 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 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 the most commonly searched types of Utilization Management jobs in Detroit, MI?

The most popular types of Utilization Management jobs in Detroit, MI are:

What are popular job titles related to Manager Utilization Management jobs in Detroit, MI?

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

What job categories do people searching Manager Utilization Management jobs in Detroit, MI look for?

The top searched job categories for Manager Utilization Management jobs in Detroit, MI are:

What cities near Detroit, MI are hiring for Manager Utilization Management jobs?

Cities near Detroit, MI with the most Manager Utilization Management job openings:

Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Detroit, MI as of August 2026, with employment types broken down into 85% Full Time, and 15% Contract. Highlights an 100% In-person job distribution, with an average salary of $90,098 per year, or $43.3 per hour.

Utilization Review Manager

Harbor Oaks Hospital

New Baltimore, MI

$25 - $35/hr

Full-time

Re-posted yesterday

Job description

Overview

Harbor Oaks Hospital is looking for a Utilization Review Manager to join our team!

Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI. 

Non-Exempt Position

Full Time Position

Monday - Friday - Day Shift 

Rate of Pay: $25.00 - $35.00 per hour (based on experience)

Responsibilities

PURPOSE STATEMENT:

Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs. 

ESSENTIAL FUNCTIONS:

  • Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
  • Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
  • Evaluate the utilization program for compliance with regulations, policies and procedures.
  • Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
  • Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

OTHER FUNCTIONS:

  • Perform other functions and tasks as assigned.
Qualifications

LICENSES/DESIGNATIONS/CERTIFICATIONS:

  • If applicable, current licensure as an LPN or RN or LPC, or LMSW or LLMSW within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility).
  • First aid may be required based on state or facility requirements.

HOAK01

#LI-HOH

Employment Type: FULL_TIME

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