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Utilization Case Manager Jobs in Michigan (NOW HIRING)

Case Manager

Detroit, MI · On-site

$55 - $60/hr

MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.

Case Manager

Detroit, MI · On-site

$58 - $60/hr

MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.

Case Manager

Livonia, MI

$18.75 - $24/hr

Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...

Case Manager

Livonia, MI · On-site

$18.75 - $24/hr

Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...

Case Manager

Livonia, MI

$18.75 - $24/hr

Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...

Facilitates appropriate utilization of resources and efficient patient progression through the ... Certification in Case Management or other related professional certification. * At least 2 years of ...

Facilitates appropriate utilization of resources and efficient patient progression through the ... Certification in Case Management or other related professional certification. * At least 2 years of ...

Facilitates appropriate utilization of resources and efficient patient progression through the ... Certification in Case Management or other related professional certification. * At least 2 years of ...

Case Manager

Ferndale, MI · On-site

$55K/yr

... service utilization eliminating any gaps in care. The Case Manager works closely with the patient's medical provider to understand what the patient's medical needs are in addition to their ...

Case Manager

Ferndale, MI · On-site

$55K/yr

... service utilization eliminating any gaps in care. The Case Manager works closely with the patient's medical provider to understand what the patient's medical needs are in addition to their ...

Case Manager

Brighton, MI · On-site

$19.25 - $24.75/hr

Case Manager - Brighton Center For Recovery Be a vital advocate at the center of patient care. In ... Serve as a clinical documentation and utilization resource , supporting accurate medical records ...

An Opportunity to Join our Remarkable Care as a Case Manager awaits YOU!!!! Trinity Health Livonia ... Five years of clinical experience in nursing and recent (within 2 year) experience in utilization ...

RN Case Manager

Pontiac, MI · On-site

$2.1K - $2.2K/wk

Requirement Description: 2+ Years Case Management - Required 3 years acute hospital care experience ... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM ...

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Utilization Case Manager information

What is a Utilization Case Manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

What does a utilization case manager do?

A utilization case manager reviews and authorizes healthcare services to ensure they are necessary and appropriate, often working with insurance companies and healthcare providers. They analyze patient records, coordinate care plans, and ensure compliance with policies, typically using case management software and requiring strong communication skills.

How does a Utilization Case Manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What jobs pay 4000 a week without a degree?

Utilization Case Managers typically do not earn $4,000 weekly without relevant experience or certifications; most roles in healthcare or social services pay less. High-paying jobs that can reach this level without a degree are rare and often involve specialized skills, sales, or entrepreneurship. Generally, achieving such income without a degree requires significant experience, licensing, or working in high-demand fields like real estate or certain trades.

What is the highest paid case manager?

The highest paid case managers are often those with advanced certifications, specialized skills, or experience in high-demand fields such as healthcare or insurance. Senior or managerial roles, such as Utilization Review Managers, can earn salaries exceeding $80,000 to $100,000 annually. Compensation varies based on location, industry, and level of responsibility.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience with medical records, patient communication, and office procedures, which can serve as a foundation for advancing in healthcare careers. However, the job's suitability depends on individual career goals and the specific workplace environment.

What are the key skills and qualifications needed to thrive as a Utilization Case Manager, and why are they important?

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

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

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What cities in Michigan are hiring for Utilization Case Manager jobs? Cities in Michigan with the most Utilization Case Manager job openings:
Case Manager

Case Manager

TEEMA

Detroit, MI • On-site

$55 - $60/hr

Contractor

Posted 14 days ago


Job description


  • 13 week contract

  • REQUIRED: 5+ years case management experience with 2+ years recent acute inpatient case management experience

  • BSN or MSW, Current MI RN licensure or LMSW, Discharge planning experience.

  • There will be limited training on site - candidates will need to be able to adapt quickly.

  • Manager will be reaching out to candidates directly for interview

  •  MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.



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About Teema

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TEEMA is an award-winning, industry-leading recruitment agency dedicated to building meaningful relationships across North America. We achieve this time after time by consistently sourcing, screening, managing and securing top talent tailored to employers’ specific needs. The team that makes this happen consists of hundreds of experienced professional recruiters backed by exceptional, tenured leadership and back-office support. No matter how unique or challenging your hiring needs may be or how misunderstood or undervalued your in-demand skills may be in your current role, we have you covered. Our primary objective is to provide an exceptional recruitment experience for our clients and candidates and an ecosystem that empowers our team to thrive.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Litchfield Park, AZ, US

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