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Utilization Management Jobs in Michigan (NOW HIRING)

UHS

Utilization Review Manager

Grand Rapids, MI

The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Utilization Review Manager

Grand Rapids, MI

The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

The Utilization Manager is responsible for directing and overseeing the Utilization Program for ... This includes the implementation of case management scenarios, consulting with all services to ...

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$34K

$78K

$142.1K

How much do utilization management jobs pay per year?

As of Jul 6, 2026, the average yearly pay for utilization management in Michigan is $77,993.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,200.00 and $91,100.00 per year, depending on experience, location, and employer.

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

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is a Utilization Management job?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a Utilization Management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the most commonly searched types of Utilization Management jobs in Michigan? The most popular types of Utilization Management jobs in Michigan are:
What are popular job titles related to Utilization Management jobs in Michigan? For Utilization Management jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Michigan look for? The top searched job categories for Utilization Management jobs in Michigan are:
What cities in Michigan are hiring for Utilization Management jobs? Cities in Michigan with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Michigan as of June 2026, with employment types broken down into 100% Full Time. Highlights an 70% In-person, 15% Hybrid, and 15% Remote job distribution, with an average salary of $77,993 per year, or $37.5 per hour.
Utilization Management Manager

Utilization Management Manager

Region 10 PIHP

Port Huron, MI

Full-time

Medical, PTO

Posted 6 hours ago

Job description

$3,000 Sign on Bonus Available!

Overview: Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. Sign on bonus of $3,000 available. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 13 paid holidays, flexible scheduling, and a comprehensive benefit program.

Essential Functions

The UM Manager position is an administrative position with responsibility in providing direction for clinical service delivery of behavioral health services across the region respective to the Utilization Management Plan, regional clinical practice guidelines, Medicaid Provider Manual and MDHHS contract requirements.

An employee at this level will be involved in the following duties, which do not include all tasks to be performed:

  • Member of Region 10 Utilization Management Committee
  • Assists with implementing regional Utilization Management Program Plan
  • Assists with the development and generation of strategies, functions, and UM/UR monitoring/evaluation reports supporting UM Program Plan Redesign implementation
  • Directs regional Utilization Review across the CMH and SUD provider networks, including case finding, review protocol updates, and quarterly and end of year reports.
  • Serves as member on Region 10 Improving Practices Leadership Team, Region 10 Credentialing and Privilegiing Committee, and other work groups as required.
  • Assists in the development and periodic evaluation of regional clinical practice guidelines
  • Facilitates and supports provider network implementation and sustainment activities pertaining to MDHHS evidence-based practices and practice standards and guidance documents
  • Provides technical guidance in clinical issues related to regional Credentialing and Privileging policy standards
  • Provides technical guidance in clinical issues related to regional Grievance and Appeal policy standards
  • Reviews UMC quarterly reports from CMHs (Behavioral Treatment Plan services, emergency use of physical management, Adverse Benefit Determination, Customer Involvement, Wellness / Healthy Communities)
  • Provides periodic reports to the Region 10 PIHP Sentinel Events Review Committee (Critical Incidents, Sentinel Events, Risk Events Management)
  • Serves as backup to the CCO on the state-wide UM Directors Group

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