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Utilization Coordinator Jobs in Michigan (NOW HIRING)

CVS Health

MI · On-site

$26.01 - $74.78/hr

Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. * Typical office working environment ...

New

UHS

UR COORDINATOR

Augusta, MI · On-site

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

UHS

UR COORDINATOR

Augusta, MI

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

UHS

UR COORDINATOR

Augusta, MI

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

CVS Health

MI · On-site

$26.01 - $68.55/hr

Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. * Typical office working environment ...

New

Corewell Health

RN Care Coordinator

Wayne, MI · On-site

Utilization Management Coordinator Part time- 20 hours a week Scope of Work: Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and ...

Corewell Health

RN Care Coordinator

Northville, MI · On-site

Part Time- 20 Hours A Week Under general direction, integrates cost, quality and utilization to ... Has accountability for the care coordination and discharge planning of all hospitalized patients.

Spectrum Health

RN Care Coordinator

Trenton, MI

Under general direction, integrates cost, quality and utilization to facilitate the admission ... Coordinating care by considering all patient's needs. * Uses critical thinking and effective ...

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Showing results 21-40

All JobsUtilization JobsUtilization Coordinator JobsUtilization Coordinator Jobs in Michigan

Utilization Coordinator information

See Michigan salary details

$13

$24

$49

How much do utilization coordinator jobs pay per hour?

As of Aug 17, 2026, the average hourly pay for utilization coordinator in Michigan is $24.07, according to ZipRecruiter salary data. Most workers in this role earn between $16.97 and $27.26 per hour, depending on experience, location, and employer.

What is a utilization coordinator?

Utilization Coordinators are healthcare professionals responsible for reviewing and monitoring the use of medical services to ensure patients receive appropriate care efficiently and cost-effectively. They assess treatment plans, review medical records, and help coordinate care among providers to ensure compliance with insurance and regulatory guidelines. Utilization Coordinators also work with clinical staff to determine the medical necessity of procedures and help optimize patient outcomes while managing healthcare costs.

How does a utilization coordinator typically interact with clinical and administrative teams in a healthcare setting?

A Utilization Coordinator regularly collaborates with both clinical teams, such as physicians and nurses, and administrative staff to ensure that patient care services are medically necessary and efficiently delivered. They review medical records, coordinate pre-authorizations, and communicate with insurance providers to support appropriate resource use. Effective communication and teamwork are essential, as Utilization Coordinators often serve as a liaison between departments, helping to resolve discrepancies and streamline processes for optimal patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization coordinator, and why are they important?

To thrive as a Utilization Coordinator, you need a background in healthcare or social services, strong analytical skills, and familiarity with medical terminology, often supported by a relevant degree or certification. Proficiency in case management software, electronic health records (EHRs), and knowledge of insurance policies and regulatory requirements is typically required. Excellent communication, organizational, and problem-solving abilities help you effectively coordinate care and advocate for patient needs. These skills ensure efficient resource utilization, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What is the difference between Utilization Coordinator vs Utilization Review Specialist?

AspectUtilization CoordinatorUtilization Review Specialist
CredentialsTypically requires healthcare-related certifications or licenses, such as a Registered Nurse (RN) or healthcare administration backgroundOften requires similar healthcare credentials, including RN, licensed practical nurse (LPN), or medical reviewer certifications
Work EnvironmentWorks in hospitals, clinics, or insurance companies, coordinating patient services and resource allocationWorks mainly in insurance companies or healthcare facilities, reviewing medical necessity and treatment plans
Employer & Industry UsageCommonly employed by healthcare providers and insurance companies to optimize resource usePrimarily employed by insurance companies and third-party payers for case reviews

While both roles involve healthcare coordination and require similar credentials, the Utilization Coordinator focuses on managing patient services and resource allocation, whereas the Utilization Review Specialist primarily reviews medical necessity and treatment plans for approval or denial.

What degree do I need for utilization review?

Utilization coordinators typically need at least a bachelor's degree in healthcare administration, nursing, or a related field. Relevant certifications, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Strong knowledge of medical terminology, insurance processes, and data management tools is also important.

What are the most commonly searched types of Utilization jobs in Michigan?

The most popular types of Utilization jobs in Michigan are:

What cities in Michigan are hiring for Utilization Coordinator jobs?

Cities in Michigan with the most Utilization Coordinator job openings:

Utilization Coordinator jobs near you
Infographic showing various Utilization Coordinator job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $50,072 per year, or $24.1 per hour.

Utilization Review Analyst HYBRID (PCN 1542)

Oakland Community Health Network

Troy, MI • On-site

$56K - $70K/yr

Full-time

Posted 25 days ago

Job description

Job Summary

Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews of service authorizations, ensuring the appropriate, effective, and efficient use of acute psychiatric inpatient and state facility services. Reviews clinical documentation to determine medical necessity and authorize service in accordance with Michigan Medicaid Provider Manual requirements, organizational policies, and applicable regulatory standards. Collaborates with network providers, hospitals, and interdisciplinary teams to support timely authorization decisions, continuity of care, and appropriate transitions across the behavioral health continuum while maintaining accurate clinical documentation and regulatory compliance.

Essential Functions

  • Conduct concurrent utilization reviews of behavioral health services for acute psychiatric hospitals, state psychiatric facilities, and other levels of care to determine medical necessity, appropriateness of admission, continued stay, and discharge in accordance with Michigan Medicaid Provider Manual requirements and applicable regulatory requirements.
  • Review and analyze clinical documentation using established medical necessity criteria, clinical guidelines, contractual requirements, and reimbursement policies to make authorization determinations for inpatient behavioral health services.
  • Collaborate with network providers, acute care hospitals, state psychiatric facilities, and interdisciplinary treatment teams to facilitate utilization review activities, continuity of care, and effective discharge planning.
  • Apply evidence-based utilization management criteria and clinical protocols to establish continued stay review intervals and determine authorization status.
  • Document clinical reviews, authorization decisions, and supporting rationale accurately and within required timeframes in accordance with organizational, contractual, and accreditation standards.
  • Utilize clinical knowledge of behavioral health services, Michigan Medicaid Provider Manual requirements and organizational policies to ensure appropriate utilization of services and compliance with applicable regulations.
  • Participate in quality improvement initiatives, interdisciplinary workgroups, provider collaboration, audits, appeals, and other utilization management and review activities to support organizational performance and regulatory compliance
  • Perform additional duties and special projects assigned.

Job Requirements and Qualifications

Education:

  • Master's degree in mental health field.

Training Requirements (licenses, programs, or certificates):

  • Possession and maintenance of a current, unrestricted State of Michigan professional license in one of the following disciplines:
    • Licensed Psychologist (LLP or LP)
    • Licensed Master's Social Worker (LMSW)
    • Licensed Professional Counselor (LPC)
    • Licensed Marriage and Family Therapist (LMFT)
    • Registered Nurse (RN)
Must maintain Child Diagnostic and Treatment Professional (CDTP) eligibility, including 24 hours of annual child-specific training.

Experience Requirements:

  • Minimum of three (3) years of relevant post-graduate clinical experience providing services to adults with mental illness, intellectual or developmental disabilities, and/or substance use disorders, as well as children with serious emotional disturbance and/or intellectual or developmental disabilities.

Preferred Experience:

  • Experience within a Community Mental Health Services Program (CMHSP), Prepaid Inpatient Health Plan (PIHP), Managed Care Organization (MCO), hospital, or behavioral health setting.
  • Experience withutilizationof the MCG Parity Tool.
  • Experience within the Oakland Community Health Network (OCHN) provider network.

Knowledge Requirements: 

  • Knowledge of the Michigan Mental Health Code. 
  • Medicaid rules, regulations, and Michigan Medicaid Provider Manual. 
  • Managed Careandutilizationmanagementprinciples.
  • Preference for knowledge of thePIHP responsibilities forutilizationmanagement. 

Job Specific Competencies/Skills:

  • Demonstrated strong interpersonal skills with a proven ability to collaborate effectively in cross-functional and team-oriented environments.
  • Skilled in negotiation and stakeholder engagement, fostering productive relationships, and achieving mutually beneficial outcomes.
  • Excellent written and verbal communication skills, with the ability to convey complex information clearly and professionally.
  • Proficient in computer applications and project management practices, ensuring efficient coordination, execution, and successful delivery of initiatives.

Oakland Community Health Network’s Core Competencies:

  • Interacting with others in a way that gives them confidence in one’s intentions and those of the organization; demonstrating loyalty to the organization and its mission and values; maintaining social, ethical, and organizational norms; firmly adhering to codes of conduct and ethical principles. (Integrity/Building Trust)
  • Making customers and their needs a primary focus of one’s actions; developing and sustaining productive customer relationships, recognizing that the ultimate customer is the person served. (Customer Focus)
  • Actively identifying new areas for learning; regularly creating and taking advantage of learning opportunities; using newly gained knowledge and skill on the job and learning through their application. (Continuous Learning)
  • Setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self-imposing standards of excellence in addition to consciously adopting organizational standards of excellence. (Work Standards)
  • Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message. (Communication)

Additional Information

(Travel required, physical requirements, schedules, etc.):

  • Must have available means of transportation to and from OCHN and for required offsite meetings or site visits.
  • Must be available for meetings and events which may occur outside of standard office hours.
  • Hybrid (onsite/remote) work schedule available.
  • The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation.

OCHN is committed to building a diverse team and fostering an inclusive and equitable culture. We are proud to be an equal opportunity employer that embraces and encourages our employees’ differences. This includes (but is not limited to) ability, age, color, family type, gender expression and identity, individual expression, medical conditions, national origin, pregnancy, race, religion, sexual orientation, veteran status, and all other diverse and wonderful characteristics.