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Utilization Management Jobs in Midland, MI (NOW HIRING)

HealthSource Saginaw

MDS / Discharge Nurse

Saginaw, MI · On-site

$31.75 - $41.50/hr

Resident Assessment Coordinator (RAC) certification or willingness to obtain within 12 months of hire. * 1-2 years of experience in MDS, RAI, case management and utilization review concepts.

MAC Trailer

Maintenance Manager

Mount Pleasant, MI · On-site

Inspect machines and equipment to ensure specific operational performance and optimum utilization * Manage the service and repair in all areas of plumbing, plastering, carpentry, painting, automotive ...

Menard, Inc

Manufacturing Manager Trainee

Saginaw, MI · On-site

$16 - $17.75/hr

Position Summary: This position is responsible for learning all production, management, and ... Come up with innovative ideas to improve current processes Facility Maintenance and Utilization

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All JobsUtilization Management JobsUtilization Management Jobs in Midland, MI

Utilization Management information

See Midland, MI salary details

$33.5K

$76.8K

$139.9K

How much do utilization management jobs pay per year?

As of Sep 8, 2026, the average yearly pay for utilization management in Midland, MI is $76,785.00, according to ZipRecruiter salary data. Most workers in this role earn between $55,300.00 and $89,700.00 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 are the most commonly searched types of Utilization Management jobs in Midland, MI?

The most popular types of Utilization Management jobs in Midland, MI are:

What are popular job titles related to Utilization Management jobs in Midland, MI?

For Utilization Management jobs in Midland, MI, the most frequently searched job titles are:

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

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

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

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

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Midland, MI as of August 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 82% Physical, 2% Hybrid, and 16% Remote job distribution, with an average salary of $76,785 per year, or $36.9 per hour.

Utilization Review Specialist Registered Nurse - Behavioral Health

McLaren

Bay City, MI • On-site

Per diem

Posted 11 days ago

Job description

Department: Behavioral Health
Daily Work Times: 7:00am - 3:00pm
Shift: Variable
Hours Per Pay Period: 0
Position Summary:
In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based on the regulatory and reimbursement requirements of various commercial and government payers. Partners with the health care team to ensure reimbursement of hospital admissions is based on medical necessity and documentation is sufficient to support the level of care being billed. Conducts concurrent reviews as directed in the hospital's UR Plan of medical records to ensure criteria for admission and continued stay are met and documented. Along with other health care team members, monitors the use of hospital resources and identifies delays. Reports delays to leadership for resolution.
Job Specific Duties and Responsibilities:
  1. Performs a variety of concurrent and retrospective utilization management-related reviews and functions to ensure that appropriate data are tracked, evaluated, and reported.
  2. Collaborates with the health care team to determine the appropriate hospital setting (inpatient vs. outpatient) based on medical necessity. Actively seeks additional clinical documentation from the physician to optimize hospital reimbursement when appropriate.
  3. Works collaboratively with case management to expedite patient discharge.
  4. Maintains current knowledge of hospital utilization review processes and participates in the resolution of retrospective reimbursement issues including appeals, PACER authorization, third party payer certification, and denied cases.
  5. Assists with monitoring the effectiveness/outcomes of the utilization management program, identifying and applying appropriate metrics, evaluating the data, reporting results to various audiences, and designing and implementing process improvement projects as needed.
  6. Identifies, develops, and provides orientation, training, and competency development for appropriate staff and colleagues on an ongoing basis.
  7. Analyzes, updates, and modifies procedures and processes to continually improve utilization review operations.
  8. Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies.
  9. Complies with federal, state, and local legal and certification requirements by studying existing and new legislation; anticipating future legislation; enforcing adherence to requirements; advising management on needed actions.
  10. Performs other related duties as required and directed.

Required
  • Nursing degree from an accredited educational institution
  • State of Michigan licensure as a Registered Nurse (RN)
  • Two years of recent clinical or utilization management experience

Preferred:
  • Bachelor's degree in nursing.
  • Three years of recent case management or utilization management experience
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About McLaren

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McLaren Group is globally renowned as one of the world’s most illustrious high-technology brands. Since the formation of McLaren Racing in 1963, McLaren has been pioneering and innovating in the competitive world of Formula 1, forging a formidable reputation which has seen the racing team win 20 World Championships and over 180 races. The Group has built on its successful racing expertise and diversified to include a global, high-performance sports car business, McLaren Automotive, and a game-changing technology and innovation business, McLaren Applied. Despite the broadening of the group’s business interests, McLaren’s goal remains singular: we exist to win in everything we do.

Industry

Automobile dealers and manufacturing

Company size

10,000+ Employees

Headquarters location

Woking, Surrey, GB

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