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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
Troy, MI · On-site +1
$160K - $160K/yr
Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This ...
Troy, MI · On-site +1
$160K - $160K/yr
Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This ...
Troy, MI · Remote
$160K - $160K/yr
Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This ...
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Troy, MI · Remote
$160K - $160K/yr
Integra's Utilization Management (UM) division is looking for an experienced individual to direct the clinical and non-clinical utilization management teams for a managed care organization. This ...
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
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
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
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
Utilization Management Clinical Analyst - Substance Use Disorder (SUD) The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of ...
Utilization Management Clinical Analyst - Substance Use Disorder (SUD) The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of ...
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 ...
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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 ...
Troy, MI · On-site
$60 - $80/hr
This position applies clinical expertise and evidence-based criteria to support timely utilization management decisions, promote appropriate resource utilization, and ensures quality, person-centered ...
Troy, MI · On-site
$60 - $80/hr
This position applies clinical expertise and evidence-based criteria to support timely utilization management decisions, promote appropriate resource utilization, and ensures quality, person-centered ...
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 ...
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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 ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
Utilization Management Clinical Analyst The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness ...
Utilization Management Clinical Analyst The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
Hospital utilization review/utilization management experience. Preferred * Clinical appeals experience. Preferred * Registered Nurse (RN) - State of Michigan Upon Hire required How Corewell Health ...
Troy, MI · On-site
$102K - $128K/yr
Job Summary The Director of Utilization Management (UM) is responsible for the strategic direction, continuous improvement, and oversight of the UM Department. This position will ensure individuals ...
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Troy, MI · On-site
$102K - $128K/yr
Job Summary The Director of Utilization Management (UM) is responsible for the strategic direction, continuous improvement, and oversight of the UM Department. This position will ensure individuals ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
$36.8K - $47.4K
15% of jobs
$47.4K - $58.1K
8% of jobs
$59.6K is the 25th percentile. Wages below this are outliers.
$58.1K - $68.7K
15% of jobs
The median wage is $75.4K / yr.
$68.7K - $79.4K
20% of jobs
$79.4K - $90K
11% of jobs
$95.3K is the 75th percentile. Wages above this are outliers.
$90K - $100.6K
13% of jobs
$100.6K - $111.3K
5% of jobs
$111.3K - $121.9K
3% of jobs
$121.9K - $132.5K
4% of jobs
$132.5K - $143.2K
3% of jobs
$143.2K - $153.8K
3% of jobs
$36.8K
$84.4K
$153.8K
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.
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.
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.
The most popular types of Utilization Management jobs in Detroit, MI are:
For Utilization Management jobs in Detroit, MI, the most frequently searched job titles are:
The top searched job categories for Utilization Management jobs in Detroit, MI are:
Cities near Detroit, MI with the most Utilization Management job openings:

Part-time
Medical, Vision, Retirement
Re-posted 4 days ago
Access insurance websites and complete duties to obtain authorization numbers for payment.
Provide clerical support for Utilization Management, including sorting faxes and mail, obtaining authorization numbers, and following up on outstanding cases.
Answer incoming calls, triage calls to appropriate personnel, and complete follow-up or problem solve issues received via phone, fax, or email.
6.9
Based on 783 frontline employees who took The Breakroom Quiz
453rd of 898 rated healthcare providers
Get the full story on Breakroom
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Hospitals
10,000+ Employees
Grand Rapids, MI, US