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Utilization Case Manager Jobs in Detroit, MI (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 · 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 · 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 ...

... 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 ...

RN Case Manager

Detroit, MI · On-site

$70 - $90/hr

... utilization to support optimal recovery and transition to the next level of care. MINIMUM REQUIRED QUALIFICATIONS * MI RN license * BLS * 1+ year case manager experience in an acute hospital setting ...

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 ...

RN- Case Manager

Pontiac, MI · On-site

$2.1K - $2.2K/wk

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

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 ...

Case Manager-SW Afternoons

Detroit, MI · On-site

$19.75 - $25.50/hr

Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...

Case Manager-SW Afternoons

Detroit, MI · On-site

$19.75 - $25.50/hr

Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...

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Utilization Case Manager information

See Detroit, MI salary details

$16

$36

$59

How much do utilization case manager jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for utilization case manager in Detroit, MI is $36.12, according to ZipRecruiter salary data. Most workers in this role earn between $29.28 and $38.08 per hour, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a utilization case manager?

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.

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 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 degree do I need for utilization case manager?

Utilization case managers typically need at least a bachelor's degree in healthcare, social work, nursing, or a related field. Some positions may prefer or require a master's degree or relevant certifications, such as Certified Case Manager (CCM) or Certified Professional in Healthcare Quality (CPHQ).

What are popular job titles related to Utilization Case Manager jobs in Detroit, MI?

For Utilization Case Manager jobs in Detroit, MI, the most frequently searched job titles are:

What job categories do people searching Utilization Case Manager jobs in Detroit, MI look for?

The top searched job categories for Utilization Case Manager jobs in Detroit, MI are:

What cities near Detroit, MI are hiring for Utilization Case Manager jobs?

Cities near Detroit, MI with the most Utilization Case Manager job openings:

Infographic showing various Utilization Case Manager job openings in Detroit, MI as of August 2026, with employment types broken down into 90% Full Time, and 10% Contract. Highlights an 100% In-person job distribution, with an average salary of $75,129 per year, or $36.1 per hour.

Utilization Management Case Manager

UHS

Auburn Hills, MI • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 6 days ago


Universal Health Services rating

6.9

Company rating: 6.9 out of 10

Based on 254 frontline employees who took The Breakroom Quiz

454th of 898 rated healthcare providers


Job description

Responsibilities
HAVENWYCK HOSPITAL (a UHS facility)
Havenwyck Hospital is a Joint Commission-accredited and licensed psychiatric hospital, overlooking Lake Galloway in Auburn Hills, Michigan. We specialize in providing comprehensive, compassionate behavioral health services to children, adolescents and adults. It is the ultimate goal of our dedicated staff to build strength, confidence and knowledge within each patient, in hopes that they may continue learning and understanding their needs and practicing self-care for the rest of their lives.
If you would like to learn more about this position before applying, please contact Havenwyck Hospital at 248-373-9200.
POSITION SUMMARY:
The Utilization Management Case Manager has a responsibility for organizing and conducting the manager care process. These duties shall be directed toward supporting the hospital's mission in the pursuit of excellence in care/service and will include (but not limited to ): conducting timely admission and continues stay record reviews with external payers, utilizing approved criteria to make determinations of medical necessity and level of care planning, verifying active treatment by completing internal audit reviews within approved time frames, assisting the treatment team when indicated in the discharge planning process, and acting as liaison with MD/Clinical Treatment Team and external agencies. Report authorizations, denials, and documentation concerns, as well as collaborate effectively across departments to minimize denials/facilitate optimal use of hospital resources.
DUTIES AND RESPONSIBILITIES:
  • Through clinical skills (experience and knowledge), reports to external insurance and review entities an accurate presentation of the medical management of a patient's illness, length of stay and care alternatives available within the confines on the client's benefits and financial resources.
  • Communicates with the Treatment Team (physicians, nursing staff, social workers, etc.) as necessary to advocate for the patient's clinical treatment within the confines on the client's benefits and financial resources.
  • Using clinical skills (experience and knowledge) assists the team in ensuring the completeness and accuracy of the medical records.
  • Performs other related duties as assigned.

BENEFIT HIGHLIGHTS:
  • Challenging and rewarding work environment
  • Competitive Compensation & Generous Paid Time Off
  • Excellent Medical, Dental, Vision and Prescription Drug Plan
  • 401(K) with company match and discounted stock plan
  • Career development opportunities within UHS and its 300+ Subsidiaries
  • Free Basic Life Insurance
  • Tuition Reimbursement
  • SoFi Student Loan Refinancing Program
  • Student Loan Repayment Program - for some degrees and criteria
What do our current employees value at Havenwyck Hospital and UHS?
An environment that puts patient care first. One of the most rewarding aspects of this job is providing excellent care, comfort, and security to the patients and families you treat, at their most vulnerable times. Supportive and responsive leadership. You are never alone, as you are part of a large network of peer co-workers that routinely exchange ideas and review current topics within the industry. Having the opportunity to grow, learn, and advance in your career. There are very robust continuing education options and opportunities for skills diversification and career advancement with UHS.
About Universal Health Services
One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500® corporation, annual revenues during 2025 were $17.4 billion. In 2026, UHS was again recognized as one of Fortune World's Most Admired Companies™ and in 2025, was listed in Forbes ranking of America's Largest Public Companies.
Headquartered in King of Prussia, PA, UHS has approximately 101,500 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom. For additional information visit www.uhs.com .
Qualifications
QUALITICATIONS:
  • Bachelor Degree in social work, psychology, counseling or nursing required. Master's degree in social work, psychology, or counseling preferred.
  • Limited or fully licensed (LBSW, RN, LLMSW, LLP, TLLP, LPC, LMFT, etc.).
  • A minimum of 2 years of post-graduate related experience in psychiatric or substance abuse treatment required. Hospital utilization review/utilization management experience preferred.
  • Familiarity with manager health care process, medical terminology, experience in case management, discharge planning, and/or utilization review preferred.

EEO Statement
All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.
We believe that diversity and inclusion among our teammates is critical to our success.
Avoid and Report Recruitment Scams
At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.
If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

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About Universal Health Services

Sourced by ZipRecruiter

Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

King of Prussia, PA, US