The Utilization Management Coordinator is responsible for performing retrospective monitoring and audit functions relative to WMCMH utilization management processes/systems. The Utilization ...
The Utilization Management Coordinator is responsible for performing retrospective monitoring and audit functions relative to WMCMH utilization management processes/systems. The Utilization ...
The Utilization Management Coordinator is responsible for performing retrospective monitoring and audit functions relative to WMCMH utilization management processes/systems. The Utilization ...
The Utilization Management Coordinator is responsible for performing retrospective monitoring and audit functions relative to WMCMH utilization management processes/systems. The Utilization ...
Utilization Management Manager
Port Huron, MI · On-site
Member of Region 10 Utilization Management Committee * Assists with implementing regional Utilization Management Program Plan * Assists with the development and generation of strategies, functions ...
Utilization Management Manager
Port Huron, MI · On-site
Member of Region 10 Utilization Management Committee * Assists with implementing regional Utilization Management Program Plan * Assists with the development and generation of strategies, functions ...
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...
Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...
Required * Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire ...
New
Required * Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * LIC-Registered Nurse (RN) - STATE_MI State of Michigan Upon Hire ...
New
Utilization Management Clerk
Lansing, MI · On-site
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Quick apply
Utilization Management Clerk
Lansing, MI · On-site
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management Clerk
Lansing, MI · On-site
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management Clerk
Lansing, MI · On-site
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Quick apply
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
Registered Nurse Looking for Utilization Management AND Education experience. Scope of work: In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral ...
... management position providing operational oversight and direction for behavioral health services utilization across the region respective to the Region 10 PIHP Access Unit and Utilization Management ...
New
... management position providing operational oversight and direction for behavioral health services utilization across the region respective to the Region 10 PIHP Access Unit and Utilization Management ...
New
Behavioral Health Utilization Management Specialist
Hastings, MI · On-site
$58K/yr
We are seeking a detail-oriented and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ...
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Behavioral Health Utilization Management Specialist
Hastings, MI · On-site
$58K/yr
We are seeking a detail-oriented and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ...
Utilization Management Clinical Analyst HYBRID (PCN 1534)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness of behavioral health ...
New
Quick apply
Utilization Management Clinical Analyst HYBRID (PCN 1534)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness of behavioral health ...
New
Utilization Management Clerk (Lansing)
Lansing, MI · On-site
$16.75 - $19.75/hr
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management Clerk (Lansing)
Lansing, MI · On-site
$16.75 - $19.75/hr
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management Clerk (Lansing)
$16.75 - $19.75/hr
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management Clerk (Lansing)
$16.75 - $19.75/hr
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of substance use disorder authorization requests to determine ...
Quick apply
Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of substance use disorder authorization requests to determine ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
UTILIZATION MANAGEMENT CLERK BENEFITS PACKAGE: Holiday Pay : New Year's Day, Martin Luther King Jr. Day, Memorial Day, Juneteenth, Independence Day, Labor Day, Veteran's Day, Thanksgiving Day, and ...
Utilization Management information
See Michigan salary details
$34K - $43.8K
15% of jobs
$43.8K - $53.6K
8% of jobs
$55K is the 25th percentile. Wages below this are outliers.
$53.6K - $63.5K
15% of jobs
The median wage is $69.7K / yr.
$63.5K - $73.3K
20% of jobs
$73.3K - $83.1K
11% of jobs
$88K is the 75th percentile. Wages above this are outliers.
$83.1K - $92.9K
13% of jobs
$92.9K - $102.8K
5% of jobs
$102.8K - $112.6K
3% of jobs
$112.6K - $122.4K
4% of jobs
$122.4K - $132.2K
3% of jobs
$132.2K - $142.1K
3% of jobs
$34K
$78K
$142.1K
How much do utilization management jobs pay per year?
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.
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- Remote Utilization Management Nurse
- Remote Utilization Management
- Utilization Review Nurse
- Full Time Cigna Utilization Review Nurse
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- Utilization Review Case Manager
- Authorization Utilization Review Bcba
- Flexible Cigna Utilization Review Nurse
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- Remote International Utilization Review Nurse
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- Utilization Case Manager
- Cigna Utilization Review Nurse

Full-time
Posted 12 days ago
Job description
The Utilization Management Coordinator is responsible for performing retrospective monitoring and audit functions relative to WMCMH utilization management processes/systems. The Utilization Management Coordinator will monitor and audit the effectiveness of the WMCMH Utilization Management processes/systems, provide data to support organizational utilization decision-making, facilitate the WMCMH Utilization Management Committee and be an active participant in the Lakeshore Regional Entity UM ROAT and other regional and state UM workgroups/committees as appropriate.
The Utilization Management Coordinator will be housed on the Operations Team and will work very closely with other members of the organization.
JOB DUTIES:
- Utilization Management – Through retrospective review and use of both strong QI principles and strong data aggregation and analysis skills, the Utilization Management Coordinator will:
- Perform monitoring and audit functions (objective examination) relative to utilization management and/or effectiveness of WM utilization management (i.e., size and composition and accessibility of WM network; appropriateness of authorization bundles; compliance with WM authorization decision guidelines; ensure presence of golden thread; ensure consistent and compliant authorization decisions and supporting documentation, etc.).
- In response to monitoring and audit functions, facilitate the development and monitoring of performance improvement plans as appropriate.
- Provide/Aggregate data to support the need for new programs and/or discontinuing programs that are ineffective or inefficient.
- Provide/Aggregate data to support the need for incorporating new or discontinuing the use of evidence-based practices.
- Provide/Aggregate data to support maintenance/updates to authorization decision guidelines.
- Facilitate the WMCMH Utilization Management Committee
- Participate in the Lakeshore Regional Entity UM ROAT and other state/regional UM workgroups as appropriate.
- Back-Up Coverage - Provide limited, short-term/backup coverage for other Operations or organizational Coordinators as needed.
About West Michigan Community Mental Health
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
51 - 200 Employees
Headquarters location
Ludington, MI, US
Year founded
1982