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Remote Utilization Review Manager Jobs in Taylor, 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

Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... 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

Prepare and maintain Utilization Review Plan policies and procedures * Obtain or maintain ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

Integra Partners

Utilization Management Coordinator

Troy, MI · Remote

$19/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes * Verify ... 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

Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes * Verify ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

Integra Partners

Utilization Management Nurse - LPN/LVN

Troy, MI · Remote

$60K - $60K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Communicate outcomes of UM authorization reviews, both verbally and in writing * Process ... Career development opportunities Remote Opportunities We are actively seeking new colleagues in:

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Remote Utilization Review Manager information

See Taylor, MI salary details

$36.2K

$84.5K

$155.5K

How much do remote utilization review manager jobs pay per year?

As of Aug 18, 2026, the average yearly pay for remote utilization review manager in Taylor, MI is $84,488.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,200.00 and $101,700.00 per year, depending on experience, location, and employer.

What is a remote utilization review manager?

A Remote Utilization Review Manager is a healthcare professional responsible for overseeing the review of medical services and determining the necessity, appropriateness, and efficiency of those services from a remote location. They ensure that healthcare providers comply with guidelines and that patients receive appropriate care without unnecessary procedures. These managers work with clinical teams, insurance companies, and regulatory agencies to optimize patient outcomes and manage healthcare costs. Working remotely allows them to perform these duties using digital health records and telecommunication tools.

What are the key skills and qualifications needed to thrive as a remote utilization review manager?

To thrive as a Remote Utilization Review Manager, you need expertise in healthcare management, case review, and regulatory compliance, typically supported by a nursing degree (RN or BSN) and relevant certifications such as CCM or URAC. Familiarity with utilization management software, electronic health records (EHRs), and payer systems is essential. Strong analytical thinking, attention to detail, and excellent communication skills help navigate complex cases and collaborate with clinical teams and insurers. These skills ensure effective resource utilization, regulatory adherence, and optimal patient outcomes in a remote healthcare environment.

What are some common challenges faced by a remote utilization review manager, and how can they be addressed?

A Remote Utilization Review Manager often encounters challenges such as maintaining effective communication with clinical teams, ensuring timely and accurate reviews, and staying updated with changing regulations and payer requirements. To address these, it's important to leverage secure collaborative platforms, establish clear workflows, and participate in ongoing training. Building strong relationships with team members and regularly reviewing protocols also help in overcoming remote work hurdles and ensuring compliance and efficiency.

What is the difference between Remote Utilization Review Manager vs Remote Utilization Review Nurse?

AspectRemote Utilization Review ManagerRemote Utilization Review Nurse
CredentialsTypically requires a nursing license, certifications like URAC or AAPC, and management experienceLicensed Registered Nurse (RN) with utilization review certification often preferred
Work EnvironmentOversees review teams, manages processes, and ensures compliance remotelyPerforms case reviews, assesses medical necessity, and documents findings remotely
Employer & Industry UsageHealth insurance companies, third-party administrators, healthcare organizations

The Remote Utilization Review Manager focuses on overseeing review teams and managing processes, while the Remote Utilization Review Nurse conducts case assessments and medical necessity reviews. Both roles require nursing credentials and are integral to healthcare utilization management, but differ in responsibilities and leadership levels.

What are popular job titles related to Remote Utilization Review Manager jobs in Taylor, MI?

For Remote Utilization Review Manager jobs in Taylor, MI, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Review Manager jobs in Taylor, MI look for?

The top searched job categories for Remote Utilization Review Manager jobs in Taylor, MI are:

What cities near Taylor, MI are hiring for Remote Utilization Review Manager jobs?

Cities near Taylor, MI with the most Remote Utilization Review Manager job openings:

Remote Utilization Review Manager jobs near you

Remote Utilization Review RN

KYYBA

Detroit, MI • Remote

$35 - $39/hr

Contractor

Medical, Dental, Vision, PTO

Posted 7 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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