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Remote Utilization Review Jobs in Rochester Hills, MI

Lancesoft

Registered Nurse

Detroit, MI · On-site +1

$30 - $35/hr

Two to four years of clinical experience which may include post-acute care, home care, acute patient care, discharge planning, case management, and utilization review, and caring for aging population ...

Curbee

Dealer Success Manager

Detroit, MI · On-site +1

$90K - $115K/yr

S. (Mobile and Remote Service). With Curbee., it's simple: dealerships send the right van to the ... Perform MBRs and QBRs, track key metrics like appointments, utilization, and review results on a ...

Hitachi Careers

Aftermarket Account Manager

MI · Remote

This is a full-time salary position that is remote . What We Offer: * Competitive wages, medical ... pipeline reviews * Monitor contract performance, renewal schedules, and customer utilization of ...

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Remote Utilization Review information

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How much do remote utilization review jobs pay per hour?

As of Jul 15, 2026, the average hourly pay for remote utilization review in Rochester Hills, MI is $38.92, according to ZipRecruiter salary data. Most workers in this role earn between $30.77 and $44.71 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Remote Utilization Review position, and why are they important?

To thrive as a Remote Utilization Review professional, you need a solid foundation in clinical knowledge, critical thinking, and an active RN or LPN license, often supported by experience in case management or prior authorization. Familiarity with medical coding (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required, along with URAC or related certifications. Excellent communication, attention to detail, and strong organizational skills help you efficiently manage cases and coordinate with providers and payers. These skills ensure accurate assessments of medical necessity, compliance with regulations, and effective remote collaboration with healthcare teams.

What does a typical day look like for someone in a Remote Utilization Review role?

A typical day for a Remote Utilization Review professional involves reviewing patient medical records, evaluating the necessity of proposed treatments against established guidelines, and collaborating with healthcare providers to gather additional information when needed. You will spend much of your time analyzing documentation, submitting recommendations, and ensuring that care authorization decisions align with payer policies and clinical best practices. Communication with case managers, physicians, and insurance representatives is frequent and essential. The work is generally independent and deadline-driven but requires strong teamwork and responsiveness through virtual meetings, emails, and calls.

What is a Remote Utilization Review job?

A Remote Utilization Review job involves assessing medical records and treatment plans to ensure they meet insurance guidelines and medical necessity criteria. Professionals in this role, often nurses or healthcare specialists, work remotely to review patient care for cost-effectiveness and compliance with policies. They collaborate with healthcare providers, insurance companies, and case managers to approve or deny services based on established guidelines. This position requires strong analytical skills, knowledge of medical policies, and attention to detail.

What are the most commonly searched types of Utilization Review jobs in Rochester Hills, MI? The most popular types of Utilization Review jobs in Rochester Hills, MI are:
What are popular job titles related to Remote Utilization Review jobs in Rochester Hills, MI? For Remote Utilization Review jobs in Rochester Hills, MI, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Review jobs in Rochester Hills, MI look for? The top searched job categories for Remote Utilization Review jobs in Rochester Hills, MI are:
What cities near Rochester Hills, MI are hiring for Remote Utilization Review jobs? Cities near Rochester Hills, MI with the most Remote Utilization Review job openings:
Remote Utilization Review jobs near you
Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote

Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote

Corporate Services

Troy, MI • Remote

Other

Re-posted 18 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

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