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Part Time Remote Utilization Review Jobs in Detroit, MI

micro1 AI

General Counsel - Remote

Detroit, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

micro1 AI

Corporate Counsel - Remote

Detroit, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

micro1 AI

Corporate Counsel - Remote

Ann Arbor, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

micro1 AI

Corporate Counsel - Remote

Sterling Heights, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

micro1 AI

General Counsel - Remote

Dearborn, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

micro1 AI

Commercial Counsel - Remote

Ann Arbor, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

micro1 AI

General Counsel - Remote

Sterling Heights, MI · Remote

$90 - $130/hr

We are seeking seasoned General Counsels for a part-time role at the forefront of legal AI. This ... In this role, you will review, assess, and contribute to contract redlining workflows used to train ...

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All JobsUtilization Review JobsPart Time Remote Utilization Review JobsPart Time Remote Utilization Review Jobs in Detroit, MI

Part Time Remote Utilization Review information

See Detroit, MI salary details

$21

$41

$68

How much do part time remote utilization review jobs pay per hour?

As of Aug 29, 2026, the average hourly pay for part time remote utilization review in Detroit, MI is $41.86, according to ZipRecruiter salary data. Most workers in this role earn between $33.08 and $48.08 per hour, depending on experience, location, and employer.

What is a part time remote utilization review?

A Part Time Remote Utilization Review position involves evaluating medical records and healthcare services to ensure they are necessary and appropriate, typically for insurance companies or healthcare providers. This job is performed remotely, allowing professionals to work from home or another location outside of a traditional office setting. Part-time roles generally require fewer hours than full-time positions, making them suitable for those seeking flexible schedules. Professionals in this role often have backgrounds in nursing or healthcare and use their expertise to review patient care for quality and cost-effectiveness.

What skills and qualifications are needed for a part time remote utilization review?

To thrive as a Part Time Remote Utilization Review Nurse, you need a current RN license, strong clinical judgment, and in-depth knowledge of medical necessity criteria and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and systems such as InterQual or MCG is typically required. Excellent communication, critical thinking, and self-motivation are vital soft skills for coordinating care and making independent decisions remotely. These skills ensure accurate case evaluations, regulatory compliance, and effective collaboration with healthcare teams while working from a remote setting.

What challenges do part time remote utilization review professionals face, and how can they be managed?

Part-time remote utilization review professionals often face challenges such as balancing a variable workload, ensuring timely communication with healthcare providers, and staying current with changing insurance guidelines. Since much of the work is done independently, strong time management and self-motivation are essential to meet review deadlines. Regularly scheduled check-ins with the team and utilizing digital collaboration tools can help maintain connectivity and support. Staying organized and proactive in seeking clarification when needed can mitigate common challenges and lead to a successful experience in this role.

What is the difference between Part Time Remote Utilization Review vs Part Time Remote Claims Reviewer?

AspectPart Time Remote Utilization ReviewPart Time Remote Claims Reviewer
CredentialsTypically requires healthcare licenses (e.g., RN, MD) and utilization review certificationsUsually requires insurance or claims processing experience, with some industry-specific certifications
Work EnvironmentRemote, healthcare-focused, reviewing medical necessity and appropriateness of careRemote, insurance or healthcare claims processing, verifying coverage and claims accuracy
Employer & Industry UsageHospitals, insurance companies, healthcare organizationsInsurance companies, third-party administrators, healthcare payers

Part Time Remote Utilization Review and Part Time Remote Claims Reviewer both operate remotely but focus on different aspects of healthcare administration. Utilization reviewers assess medical necessity, while claims reviewers verify insurance claims. Understanding these differences helps job seekers find roles aligned with their skills and credentials.

What are the most commonly searched types of Remote Utilization Review jobs in Detroit, MI?

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

What job categories do people searching Part Time Remote Utilization Review jobs in Detroit, MI look for?

The top searched job categories for Part Time Remote Utilization Review jobs in Detroit, MI are:

What cities near Detroit, MI are hiring for Part Time Remote Utilization Review jobs?

Cities near Detroit, MI with the most Part Time Remote Utilization Review job openings:

Part Time Remote Utilization Review jobs near you
Infographic showing various Part Time Remote Utilization Review job openings in Detroit, MI as of August 2026, with employment types broken down into 100% Part Time. Highlights an 100% Remote job distribution, with an average salary of $87,064 per year, or $41.9 per hour.

Utilization Review Medical Director (Contract)

Troy, MI • On-site, Remote

Integra Partners
Health Care and Social Assistance • 201 - 500 employees
Learn more about Integra Partnersexternal

$150/hr

Part-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

New

Job description

The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment (DME) and related requests to support Integra's Utilization Management (UM) operations. This full-time, salaried role functions within a structured, high-volume authorization review queue and requires adherence to workflow timelines, clinical accuracy standards, and productivity expectations. The Medical Director ensures determinations are made in accordance with Medicare and Medicaid guidelines, health plan-specific criteria, internal policies, and regulatory requirements. This role is best suited for physicians who thrive in a process-driven environment and are committed to consistency, compliance, and evidence-based decision making.
The Utilization Review Medical Director's responsibilities include but are not limited to:
  • Conduct timely clinical reviews of DMEPOS authorization requests using applicable criteria, including LCDs, Medicaid Manuals, InterQual, MCG, internal medical policies, and health plan requirements.
  • Function within a real-time review queue and maintain continuous case throughput in alignment with organizational turnaround and productivity standards.
  • Evaluate clinical documentation, identify missing elements, and render determinations supported by clear clinical rationale.
  • Review cases escalated by UM staff and/or UM Leadership when criteria do not apply to the enrollee's unique clinical situation or when clinical judgment is required.
  • When appropriate, consult with external board-certified reviewers, engage with ordering practitioners, or conduct additional clinical dialogue prior to rendering a determination.
  • Participate in Peer-to-Peer (P2P) discussions, including maintaining availability for scheduled appointment times.
  • Document all clinical decisions clearly, concisely, and consistently in accordance with internal SOPs, NCQA standards, and regulatory expectations.
  • Maintain inter-rater reliability and participate in periodic calibration reviews to support consistency across the UM program.
  • Serve as a clinical resource for UM team, providing guidance on clinical interpretation, criteria application, and complex case review.
  • Support internal and external audit activities as needed, including NCQA accreditation, health plan audits, and state Medicaid reviews.
  • Notify leadership of observed trends, potential quality concerns, or opportunities to strengthen criteria alignment or operational workflows.
  • Maintain up-to-date knowledge of Medicare, Medicaid, DMEPOS policies, clinical standards of care, and regulatory updates relevant to UM.
Requirements:
  • MD or DO degree
  • Board certification in Internal Medicine, Family Medicine, or Physical Medicine & Rehabilitation
  • Eligible for participation in Medicare, Medicaid, and other federally funded programs; no current or past OIG or state sanctions
  • Experience performing utilization management or clinical review activities
  • Strong written and verbal communication skills with emphasis on documentation accuracy
  • Ability to work effectively in a high-volume, queue-based workflow with daily review expectations
  • Familiarity with electronic UM systems and authorization platforms
  • Experience with DMEPOS reviews
  • Experience with NCQA UM accreditation standards
  • Prior UM experience for MLTC, Medicaid, or Medicare Advantage plans

Working Conditions and Additional Expectations:
  • Full-time remote role requiring consistent availability during standard business hours and responsiveness to daily assignments.
  • Case volume and mix vary; continuous throughput and timely review completion are required.
  • Must maintain a quiet, secure, and compliant environment for reviewing PHI and participating in P2P calls.
  • Secondary employment or consulting arrangements are permitted only if they do not interfere with the full-time expectations and require disclosure/approval.
  • Daily accountability measures, productivity monitoring, and adherence to all UM workflows are required.

Salary: $150.00/Hourly
Benefits Offered
  • Competitive compensation and annual bonus program
  • 401(k) retirement program with company match
  • Company-paid life insurance
  • Company-paid short term disability coverage (location restrictions may apply)
  • Medical, Vision, and Dental benefits
  • Paid Time Off (PTO)
  • Paid Parental Leave
  • Sick Time
  • Paid company holidays and floating holidays
  • Quarterly company-sponsored events
  • Health and wellness programs
  • Career development opportunities

Remote Opportunities
We are actively seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Kentucky, Massachusetts, Michigan, North Carolina, Nevada, New Jersey, New York, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and Washington.
Our Story
Founded in 2005, Integra Partners is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the quality of life for the communities we serve by reimagining access to in-home healthcare. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members access to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver better health outcomes and more efficient management of complex healthcare benefits.
With a location in Michigan plus a remote workforce across the United States, Integra has a culture focused on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We're looking for energetic, talented, and dedicated individuals to join our team. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in healthcare. We look forward to learning more about you.
Integra Partners is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don't hesitate to reach out. We celebrate our inclusive work environment and welcome members of all backgrounds and perspectives.

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