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Utilization Management Jobs in Clarkston, MI (NOW HIRING)

Spectrum Health

Utilization Mgmt Spec

Southfield, MI · On-site

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 ...

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

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 ...

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

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 ...

OpTech LLC

RN Utilization Management

Detroit, MI · On-site

Utilization Management experience/role * Technical - MS Office, Type 35+ WPM, Dual monitors, multiple systems * 1 yr health insurance plan experience or managed care environment preferred

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Utilization Management information

See Clarkston, MI salary details

$39.9K

$91.5K

$166.6K

How much do utilization management jobs pay per year?

As of Sep 8, 2026, the average yearly pay for utilization management in Clarkston, MI is $91,466.00, according to ZipRecruiter salary data. Most workers in this role earn between $65,900.00 and $106,800.00 per year, depending on experience, location, and employer.

What is utilization management?

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 key skills and qualifications needed to thrive in utilization management, 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

What job categories do people searching Utilization Management jobs in Clarkston, MI look for?

The top searched job categories for Utilization Management jobs in Clarkston, MI are:

What cities near Clarkston, MI are hiring for Utilization Management jobs?

Cities near Clarkston, MI with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Clarkston, MI as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution, with an average salary of $91,466 per year, or $44 per hour.

Utilization Mgmt Spec

Spectrum Health

Southfield, MI • On-site

Part-time

Medical, Vision, Retirement

Re-posted 2 days ago

Job description

Job Summary

Under general direction, assists in the provision of the highest service level possible to patients/customers to ensure their satisfaction. Participates in activities with third party payors in order to maximize reimbursement.

Essential Functions
  • Understands and accesses insurance websites. Completes required duties as defined for specific payers to obtain authorization numbers for payment.
  • 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 outpatient or inpatient status.
  • Utilizes electronic medical record work queues that support Utilization Management functions.
  • Answers incoming calls or places outbound calls with appropriate communication skills. Triages all calls to the appropriate person for resolution and action or completes appropriate follow-up.
  • Problem solves issues that are received via phone, fax or email.
  • Other duties as assigned.
Qualifications

Required

  • High School Diploma or G.E.D. completion required.

Preferred

  • Post high school training and/or academic coursework leading toward associate or bachelor's degree
  • Two years of healthcare experience
  • Competency and comprehension of basic medical terminology. Well-developed computer skills and/or business-related software/application literacy.

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.


How Corewell Health cares for you
  • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
  • On-demand pay program powered by Payactiv
  • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
  • Optional identity theft protection, home and auto insurance
  • Traditional and Roth retirement options with service contribution and match savings
  • Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Corewell Health Southfield Center - 26901 Beaumont Blvd

Department Name

Utilization Management - Diversified East WB Mkt

Employment Type

Part time

Shift

Day (United States of America)

Weekly Scheduled Hours

20

Hours of Work

Variable

Days Worked

Monday - Saturday

Weekend Frequency

Variable weekends

CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

You may request assistance in completing the application process by calling 616.486.7447.

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