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Remote Utilization Management Jobs in Fenton, MI

KYYBA

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Remote Utilization Review RN

Detroit, MI · Remote

$35 - $39/hr

  • Medical

  • Dental

  • Vision

  • PTO

Utilization Review RN Contract Duration: 12+ months Job Location: 100% REMOTE License Requirements ... Minimum 5 years of healthcare experience . * 3-5 years of Utilization Management experience ...

Integra Partners

Director of Utilization Management

Troy, MI · On-site +1

$160K - $160K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Integra's Utilization Management (UM) division is looking for an experienced individual to direct ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

Integra Partners

Director of Utilization Management

Troy, MI · Remote

$160K - $160K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Integra's Utilization Management (UM) division is looking for an experienced individual to direct ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

Integra Partners

Utilization Management Coordinator

Troy, MI · On-site +1

$19/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

New

Integra Partners

Utilization Management Coordinator

Troy, MI · Remote

$19/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

... to processing Utilization Management prior authorization sand appeals. JOB RESPONSIBILITIES ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

New

Integra Partners

Medical Coding Specialist

Troy, MI · On-site +1

$65K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Medical Coding Specialist provides coding expertise to support Utilization Management ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

Integra Partners

Medical Coding Specialist

Troy, MI · Remote

$65K - $65K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

The Medical Coding Specialist provides coding expertise to support Utilization Management ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

Amgen

Field Reimbursement Manager

Detroit, MI · On-site +1

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

... utilization management criteria, insurance forms & procedures, benefits investigation, prior ... General office demands - Remote, Work from Home. * One to two home office days per week. * Must be ...

COMPASSUS

Insurance Specialist

Flint, MI · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

COMPASSUS

Insurance Specialist

Farmington Hills, MI · Remote

$20 - $35/hr

Compassus This is a remote position for candidates located in the Central Time Zone. Position ... Utilization management experience and pre-certification helpful. * Customer service experience ...

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All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Fenton, MI

Remote Utilization Management information

See Fenton, MI salary details

$19

$38

$62

How much do remote utilization management jobs pay per hour?

As of Aug 14, 2026, the average hourly pay for remote utilization management in Fenton, MI is $38.17, according to ZipRecruiter salary data. Most workers in this role earn between $30.14 and $43.85 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 in remote utilization management?

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 popular job titles related to Remote Utilization Management jobs in Fenton, MI?

For Remote Utilization Management jobs in Fenton, MI, the most frequently searched job titles are:

What cities near Fenton, MI are hiring for Remote Utilization Management jobs?

Cities near Fenton, MI with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Fenton, MI as of July 2026, with employment types broken down into 96% Full Time, and 4% Contract. Highlights an 100% Remote job distribution, with an average salary of $79,389 per year, or $38.2 per hour.

Remote Utilization Review RN

KYYBA

Detroit, MI • Remote

$35 - $39/hr

Contractor

Medical, Dental, Vision, PTO

Posted 4 days ago

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Job description

Job Title: Utilization Review RN
Contract Duration: 12+ months
Job Location: 100% REMOTE
License Requirements: MI Registered Nurse License

Mandatory Requirements to Apply

  • Active, unrestricted Michigan Registered Nurse (RN) license required.
  • Nursing Diploma or Associate Degree in Nursing required; BSN preferred.
  • 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, utilization management, and clinical documentation.
  • Working knowledge of ICD-10 and CPT coding.

Roles & Responsibilities

  • Deliver clinical education and training for Care Management and Utilization Management staff, including onboarding, mentoring, and ongoing professional development.
  • Conduct quality reviews, internal and external audits, and analyze performance to support accreditation and continuous quality improvement initiatives.
  • Develop, maintain, and update training materials, manuals, and educational resources reflecting system updates, InterQual criteria, and departmental processes.
  • Collaborate with leadership and subject matter experts to implement new programs, systems, and process improvements while supporting change management initiatives.
  • Coordinate training operations, including scheduling, class administration, new hire system access, attendance tracking, and communication with internal teams and external provider facilities.

Salary & Benefits

  • Pay: $35–$39 per hour
  • Health Insurance (Medical, Dental and Vision)
  • 9 Days of Paid Time Off
  • All equipment provided by the client

Company Description

Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances.

At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.

Kyyba is an Equal Opportunity Employer.

Kyyba does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other b

KYYBA logo

About KYYBA

Sourced by ZipRecruiter

About Kyyba: Founded in 1998 and headquartered in Farmington Hills, MI, Kyyba has a global presence delivering high-quality resources and top-notch recruiting services, enabling businesses to effectively respond to organizational changes and technological advances. At Kyyba, the overall well-being of our employees and their families is important to us. We are proud of our work culture which embodies our core values; incorporating value, passion, excellence, empowerment, and happiness, creates a vibrant and productive atmosphere. We empower our employees with the resources, incentives, and flexibility that they need to support a healthy, balanced, and fulfilling career by providing many valuable benefits and a balanced compensation structure combined with career development.

Industry

Recruiting and staffing services

Company size

501 - 1,000 Employees

Headquarters location

Farmington Hills, MI, US

Year founded

1998

Social media

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