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Utilization Management Jobs in Rochester Hills, MI

Ambition 24Hours Inc

Director Case Management

Detroit, MI · On-site

$103K - $155K/yr

... hospital utilization management, transition management, care coordination, and operational ... leadership within a high-volume acute care hospital setting. This role is responsible for driving ...

TH Medical

Director - Case Management

Detroit, MI · On-site

Utilization Management supporting medical necessity and denial prevention Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction Care Coordination ...

Trinity Health

ECT Coordinator

Livonia, MI · On-site

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES MAY INCLUDE 1. Provides leadership and expertise for utilization management processes. 2. Completes the UR review and obtains authorization on retrospective ...

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All JobsUtilization Management JobsUtilization Management Jobs in Rochester Hills, MI

Utilization Management information

See Rochester Hills, MI salary details

$35.9K

$82.4K

$150K

How much do utilization management jobs pay per year?

As of Jun 15, 2026, the average yearly pay for utilization management in Rochester Hills, MI is $82,364.00, according to ZipRecruiter salary data. Most workers in this role earn between $59,400.00 and $96,200.00 per year, depending on experience, location, and employer.

What jobs pay 4000 a week without a degree?

Utilization Management roles typically require healthcare or insurance industry knowledge and often a relevant certification rather than a degree. High-paying jobs that can reach $4,000 a week without a degree include sales positions, real estate brokers, commercial pilots, or skilled trades like electricians and plumbers, especially with experience and certifications. These roles often involve commission, bonuses, or overtime to achieve such earnings.

What jobs pay $2000 a day?

Jobs that can pay $2000 a day typically include specialized roles such as senior management, high-level consultants, certain medical specialists, and experienced legal professionals. These positions often require advanced skills, extensive experience, and sometimes certifications, and they may involve freelance or contract work with high hourly or project-based rates.

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 is the least stressful healthcare job?

Utilization management roles are often considered less stressful compared to direct patient care jobs because they involve reviewing medical necessity and insurance claims rather than providing hands-on treatment. These positions typically have regular hours, less physical demand, and focus on administrative tasks, making them a lower-stress option within healthcare. However, stress levels can vary based on workplace environment and individual preferences.

What does utilization management do?

Utilization management is a healthcare job that involves reviewing and approving or denying medical services to ensure they are necessary and appropriate. It helps control healthcare costs and maintains quality by evaluating treatment plans, often using guidelines and data analysis. Professionals in this role typically work with insurance companies, healthcare providers, and use tools like medical records and clinical criteria.

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 popular job titles related to Utilization Management jobs in Rochester Hills, MI? For Utilization Management jobs in Rochester Hills, MI, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Rochester Hills, MI look for? The top searched job categories for Utilization Management jobs in Rochester Hills, MI are:
What cities near Rochester Hills, MI are hiring for Utilization Management jobs? Cities near Rochester Hills, MI with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Rochester Hills, MI as of June 2026, with employment types broken down into 94% Full Time, and 6% Contract. Highlights an 88% In-person, 6% Hybrid, and 6% Remote job distribution, with an average salary of $82,364 per year, or $39.6 per hour.
Group Director - Utilization Review

Group Director - Utilization Review

TH Medical

Detroit, MI

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 20 days ago

Job description

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At The Detroit Medical Center (DMC), we're seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.

Benefit Statement    

At Tenet Healthcare, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:  
Medical, dental, vision, and life insurance
401(k) retirement savings plan with employer match
Generous paid time off (PTO)  
Career development and continuing education opportunities 
Health savings accounts, healthcare & dependent flexible spending accounts
Employee Assistance program, Employee discount program
Voluntary benefits include pet insurance, legal insurance, accident and critical illness 
insurance, long term care, elder & childcare, auto & home insurance.
Note: Eligibility for benefits may vary by location and is determined by employment status              
  

Summary:

The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated Market. Will support the advancement of Centralized Utilization Review as a leader, mentor, and consultant. Will execute on strategic initiatives and will provide subject matter expertise for Case Management - Utilization Review regulations and standards, including ensuring compliance with all state and federal regulations.

POSITION SPECIFIC RESPONSIBILITIES:
The Group Director will be responsible for developing and maintaining procedure manuals for such activities as: UM annual work plan/evaluation and quarterly and semi-annual UM reports; oversight of daily operations of the UM team and optimizing denial mitigation processes.
Will partner with the Group DCM and Hospital Case Mgt. Leaders relating to Case Management scope of services, including utilization management, transition management promoting appropriate length of stay, readmission prevention and patient satisfaction. Will ensure effective utilization of resources, timely and accurate revenue cycle processes, denial prevention, and safe and timely patient throughput. Will integrate national standards for utilization management supporting medical necessity and denials prevention.

QUALIFICATIONS:

  Bachelor's degree in business, nursing or health care administration required. Advanced degree in business, nursing and/or healthcare administration, health science or related discipline preferred.

       A minimum of 5 years' experience in hospital revenue cycle function. Five (5) years in hospital Utilization Review Leadership preferred. Multi-site leadership experience preferred. Experience successfully implementing centralized Utilization Review teams for multi-hospital system strongly preferred. Working knowledge of CarePort and MIDAS documentation and reporting required. Project Management and Business Planning experience; strong analytical skills including use of Tableau and Excel; executive communication and presentation skills including ability to use PowerPoint.

       Accredited Case Manager (ACM) or Certified Public Accountant (CPA) preferred, Six Sigma Green Belt preferred

       Valid Registered Nurse (RN) preferred

PHYSICAL DEMANDS:

-Lift/position up to 25 lbs. Push/pull up to 25 lbs of force.

-Frequent sitting. Moderate standing, walking, reaching, stooping, and bending

-Manual dexterity, mobility, touch, auditory to perform all the related duties of the position

Facility Description

The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan and beyond.  A premier healthcare resource, our mission is to help people live happier, healthier lives.  The hospitals of the Detroit Medical Center are the Children's Hospital of Michigan, Detroit Receiving Hospital, Harper University Hospital, Hutzel Women's Hospital, the DMC Heart Hospital, Huron Valley-Sinai Hospital, the Rehabilitation Institute of Michigan and Sinai-Grace Hospital. 

DMC's 150-year legacy of medical excellence and service provides patients and families world-class care in cardiovascular health, women's services, neurosciences, stroke treatment, orthopedics, pediatrics, rehabilitation, organ transplant and other general and specialty services.  

DMC is a key partner in Detroit's resurgence, which continues to draw national and international attention.  A dedicated corporate citizen with strong community ties, DMC is one of the largest and most diverse employers in Southeast Michigan.

EEO Statement

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other 13 legally protected status.

Tenet will make reasonable accommodation for qualified individuals with disabilities unless doing so would result in an undue hardship.

Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify

The employment practices of Tenet Healthcare and its companies comply with all applicable laws and regulations    

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