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Remote Utilization Management Jobs in Michigan (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Ypsilanti, MI · On-site +1

$51.75 - $63/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Detroit, MI · On-site +1

$52.50 - $63.75/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

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$18

$36

$60

How much do remote utilization management jobs pay per hour?

As of Jun 18, 2026, the average hourly pay for remote utilization management 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.

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What are the key skills and qualifications needed to thrive as a Remote Utilization Management Nurse, and why are they important?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

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 Remote Utilization Management jobs in Michigan? For Remote Utilization Management jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Michigan look for? The top searched job categories for Remote Utilization Management jobs in Michigan are:
What cities in Michigan are hiring for Remote Utilization Management jobs? Cities in Michigan with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Michigan as of June 2026, with employment types broken down into 85% Full Time, 14% Part Time, and 1% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $76,654 per year, or $36.9 per hour.
Utilization Management Coordinator

Utilization Management Coordinator

Integra Partners

Troy, MI • On-site, Remote

$19/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 3 days ago

Job description

The UM Coordinator assists and supports the clinical team (UM Nurses/Medical Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand appeals.
JOB RESPONSIBILITIES
  • Monitor incoming faxes
  • Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes
  • Verify eligibility and claim history in proprietary claims platform
  • Verify all necessary documentation has been submitted with authorization requests
  • Contact requesting providers to obtain medical records or other necessary documentation related to specific UM request
  • Generate correspondence and assist with faxing/mailing member and provider notifications
  • Complete verbal notifications
  • Document as required in authorization platform
  • Initiate appeal cases and forward to UM Nurses for completion
  • Meet internal and regulator deadlines for UM cases
  • Complete tasks assigned by UM Nurses and document as required
  • Complete inquiries received from call center and other internal & external sources
  • Other duties as assigned by UM Director
  • Strong organizational skills, ability to adapt quickly to change and desire to work in a fast-paced environment
  • Team oriented and self-motivated with a positive attitude

Pay: $19.00/hour
What will you learn in the first 6 months?
  • Verbal notifications
  • How to work in authorization systems Essette and Salesforce
  • Incoming/outgoing faxing process
  • Understanding the expectations and functions of the UM team
  • Time Management

What will you achieve in the first 12 months?
  • Expand knowledge of ICD-10 and HCPC codes
  • Maintaining expected timelines

EXPERIENCE:
  • 1 year as a UM Coordinator in a managed care payer environment preferred
  • Knowledge of ICD-10, HCPCS codes and medical terminology required
  • Ability to prioritize multiple tasks using time management and organizational skills
  • Strong computer skills with proficiency in Word, Outlook and other software applications
  • Ability to collect data, establish facts and draw valid conclusions
  • Effective written and oral communication skills
  • Experience with DMEPOS desired
  • Medicare/Medicaid experience a plus

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. Integra Partners is a wholly owned subsidiary of Point32Health.
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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