Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * RHIT, RHIA, or related coding certification required. Additional Information
Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * RHIT, RHIA, or related coding certification required. Additional Information
Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * RHIT, RHIA, or related coding certification required.
Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * RHIT, RHIA, or related coding certification required.
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
Opportunity for an RN who has a US license in good standing to join our Medicaid Team as a Clinical ... Essential Job Duties Performs audits in utilization management, care management, member assessment ...
Remote Community Based Clinical Coordinator - Care Manager- Luce County, MI
Newberry, MI · On-site +1
$29.72/hr
... nursing facilities. Serves as a member's single point of contact; gathers vital health history and ... Utilization Management (UM), Quality Improvement (QI), Care Management, and Member's Rights and ...
Remote Community Based Clinical Coordinator - Care Manager- Luce County, MI
Newberry, MI · On-site +1
$29.72/hr
... nursing facilities. Serves as a member's single point of contact; gathers vital health history and ... Utilization Management (UM), Quality Improvement (QI), Care Management, and Member's Rights and ...
Remote Community Based Clinical Coordinator - Care Manager - Mackinac County, MI
Saint Ignace, MI · On-site +1
$29.72/hr
... nursing facilities. Serves as a member's single point of contact; gathers vital health history and ... Utilization Management (UM), Quality Improvement (QI), Care Management, and Member's Rights and ...
Remote Community Based Clinical Coordinator - Care Manager - Mackinac County, MI
Saint Ignace, MI · On-site +1
$29.72/hr
... nursing facilities. Serves as a member's single point of contact; gathers vital health history and ... Utilization Management (UM), Quality Improvement (QI), Care Management, and Member's Rights and ...
Remote Community Based Clinical Coordinator - Care Manager- Chippewa County, MI
Sault Sainte Marie, MI · On-site +1
$29.72/hr
... nursing facilities. Serves as a member's single point of contact; gathers vital health history and ... Utilization Management (UM), Quality Improvement (QI), Care Management, and Member's Rights and ...
Remote Community Based Clinical Coordinator - Care Manager- Chippewa County, MI
Sault Sainte Marie, MI · On-site +1
$29.72/hr
... nursing facilities. Serves as a member's single point of contact; gathers vital health history and ... Utilization Management (UM), Quality Improvement (QI), Care Management, and Member's Rights and ...
Director, Trade Client Relations
Three Rivers, MI · Remote
$155K - $175K/yr
... and utilization management strategies * Client Relations - Serve as Trade's primary point of ... Work is generally performed in a remote setting. #LI-Remote $155,000.00 - $175,000.00 This is the ...
Director, Trade Client Relations
Three Rivers, MI · Remote
$155K - $175K/yr
... and utilization management strategies * Client Relations - Serve as Trade's primary point of ... Work is generally performed in a remote setting. #LI-Remote $155,000.00 - $175,000.00 This is the ...
Medical Coding Specialist
Troy, MI · On-site +1
$65K - $65K/yr
The Medical Coding Specialist provides coding expertise to support Utilization Management ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
Medical Coding Specialist
Troy, MI · On-site +1
$65K - $65K/yr
The Medical Coding Specialist provides coding expertise to support Utilization Management ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:
... ) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team ...
... ) to serve our patient population in the navigation, prevention and management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Multi-State Nurse Practitioner (NP) - Contracted Location: Remote -- United States THE HIGHLIGHTS ... We provide expert diabetes education and clinical management for Medicare patients, delivered by a ...
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Multi-State Nurse Practitioner (NP) - Contracted Location: Remote -- United States THE HIGHLIGHTS ... We provide expert diabetes education and clinical management for Medicare patients, delivered by a ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
Sterling Heights, MI · Remote
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Case Manager Registered Nurse (LTSS) - Field MI (Wayne and Macomb County)
Sterling Heights, MI · Remote
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Document all case management activities in accordance with regulatory and accreditation standards ... Remote Work Expectations * This is a remote role with 25-50% travel required, candidates must have ...
Nurse Practitioner: Remote Urgent Care
Detroit, MI · Remote
$109K - $151K/yr
Belle trains and manages a network of nail technicians or "Belle Technicians" who provide in-home ... As these issues arise, a team of remote nurses coordinate care with other healthcare providers ...
Nurse Practitioner: Remote Urgent Care
Detroit, MI · Remote
$109K - $151K/yr
Belle trains and manages a network of nail technicians or "Belle Technicians" who provide in-home ... As these issues arise, a team of remote nurses coordinate care with other healthcare providers ...
Remote Utilization Management Nurse information
See Michigan salary details
$18.65 - $22.42
2% of jobs
$22.42 - $26.19
9% of jobs
$28.77 is the 25th percentile. Wages below this are outliers.
$26.19 - $29.96
21% of jobs
The median wage is $33.01 / hr.
$29.96 - $33.73
23% of jobs
$33.73 - $37.50
13% of jobs
$40.44 is the 75th percentile. Wages above this are outliers.
$37.50 - $41.28
10% of jobs
$41.28 - $45.05
8% of jobs
$45.05 - $48.82
5% of jobs
$48.82 - $52.59
5% of jobs
$52.59 - $56.36
2% of jobs
$56.36 - $60.13
2% of jobs
$18
$36
$60
How much do remote utilization management nurse jobs pay per hour?
As of Aug 1, 2026, the average hourly pay for remote utilization management nurse 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 is the difference between Remote Utilization Management Nurse vs Remote Case Manager?
| Aspect | Remote Utilization Management Nurse | Remote Case Manager |
|---|---|---|
| Credentials | RN license, certifications like CCM or ANCC | RN license, certifications like CCM or similar |
| Work Environment | Healthcare organizations, insurance companies, telehealth | Insurance companies, healthcare providers, telehealth |
| Job Focus | Reviewing medical necessity, authorizations, and utilization | Coordinating patient care, discharge planning, resource management |
Both roles require RN licensure and similar certifications, often working remotely within healthcare or insurance settings. The main difference lies in focus: Utilization Management Nurses primarily review medical necessity and authorization requests, while Case Managers coordinate patient care and discharge planning. Understanding these distinctions helps job seekers identify the role that best matches their skills and career goals.
What is a Remote Utilization Management Nurse?
A Remote Utilization Management Nurse is a registered nurse who works from a remote location, such as their home, to review patient medical records and determine the necessity, appropriateness, and efficiency of healthcare services. They collaborate with healthcare providers and insurance companies to ensure that patients receive appropriate care while managing costs. Their main responsibilities include reviewing clinical documentation, conducting pre-authorization reviews, and ensuring compliance with healthcare regulations and insurance guidelines.
What Does a Remote Utilization Management Nurse Do?
As a remote utilization management nurse, you work from home to perform a variety of duties and responsibilities, such as corresponding with and interviewing physicians, modifying patient treatment plans, analyzing investigation information, and auditing patient records. As a UM nurse, you may also deal with other clinical tasks, referrals, authorizations, and reviews. You usually work for insurance companies and healthcare providers to help to determine if patients should receive authorization for needed treatments or for those that they already receive. In some cases, you may monitor processes to ensure that hospital patients are getting what they need during their stay.
What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?
To thrive as a Remote Utilization Management Nurse, you need a valid RN license, clinical experience (often in acute care), and a solid understanding of utilization review and healthcare regulations. Familiarity with case management software, electronic medical records (EMRs), and tools like InterQual or Milliman Care Guidelines is typically required. Strong analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for successful remote collaboration and decision-making. These skills ensure accurate assessments, compliance with standards, and the delivery of cost-effective, quality patient care from a remote setting.
What are some common challenges faced by Remote Utilization Management Nurses, and how can they be addressed?
Remote Utilization Management Nurses often face challenges such as maintaining effective communication with interdisciplinary teams, staying updated on changing insurance guidelines, and managing a high volume of case reviews. To address these issues, it's helpful to establish regular virtual check-ins with team members, utilize digital tools for efficient documentation, and participate in ongoing training on payer requirements. Developing strong organizational skills and proactively seeking clarification on complex cases can also contribute to success in this role.
More about Remote Utilization Management Nurse jobs
What are the most commonly searched types of Utilization Management Nurse jobs in Michigan? The most popular types of Utilization Management Nurse jobs in Michigan are:
What are popular job titles related to Remote Utilization Management Nurse jobs in Michigan? For Remote Utilization Management Nurse jobs in Michigan, the most frequently searched job titles are:
- Remote Cvs Utilization Management Nurse
- Flex Schedule Remote Utilization Review Nurse
- Seasonal Remote Hedis Review Nurse
- No Experience Utilization Review Nurse
- Utilization Review Nurse
- Weekend Physician Advisor Utilization Review
- No Experience Utilization Management Nurse
- Remote Chart Review Nurse
- Evening Utilization Review Nurse
- Medicare Review Nurse
What job categories do people searching Remote Utilization Management Nurse jobs in Michigan look for? The top searched job categories for Remote Utilization Management Nurse jobs in Michigan are:
- Dental Utilization Review
- Full Time Cigna Utilization Review Nurse
- Remote Hca Utilization Review
- Remote Insurance Utilization Review
- Temporary Aetna Utilization Review Nurse
- Remote Bcba Utilization Review
- Utilization Review Manager
- From Home International Utilization Review Nurse
- Remote Supervisor Utilization Management
- Optum Utilization Review Nurse
What cities in Michigan are hiring for Remote Utilization Management Nurse jobs? Cities in Michigan with the most Remote Utilization Management Nurse job openings:
Other
Re-posted 6 days ago
Job description
In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient. You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
- RHIT, RHIA, or related coding certification required.
- Minimum 3-5 years of clinical experience preferred.
- Previous utilization management or case management experience preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
- RHIT, RHIA, or related coding certification required.
Additional Information
- Organization: Corporate Services
- Department: Central Utilization Mgt
- Shift: Day Job
- Union Code: Not Applicable