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Utilization Manager Jobs in Michigan (NOW HIRING)

Lthc

Utilization Management Services Rep I

Dewitt, MI · On-site

$13.50 - $18.25/hr

This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. This position acts as a resource for both internal and external customers ...

Lthc

Utilization Management Services Rep I

Dewitt, MI · On-site

$13.50 - $18.25/hr

This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. This position acts as a resource for both internal and external customers ...

Bestica Healthcare

RN - Utilization Review

Lansing, MI · On-site

Utilization Review Rn Travel Position We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative.

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All JobsUtilization Manager JobsUtilization Manager Jobs in Michigan

Utilization Manager information

See Michigan salary details

$34K

$79.3K

$146K

How much do utilization manager jobs pay per year?

As of Jul 4, 2026, the average yearly pay for utilization manager in Michigan is $79,325.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,900.00 and $95,400.00 per year, depending on experience, location, and employer.

What does a utilization manager do?

A utilization manager oversees the allocation and efficient use of resources, such as staff and equipment, to meet organizational goals. They analyze data, monitor utilization rates, and ensure compliance with policies, often using tools like spreadsheets or specialized software. This role requires strong organizational and communication skills to optimize productivity and control costs.

What jobs pay 4000 a week without a degree?

Utilization Managers typically require a relevant background in healthcare, logistics, or operations, and their salaries usually do not reach $4,000 weekly without specialized experience or certifications. High-paying roles that can reach this level without a degree often include sales, real estate, or skilled trades like certain construction or technical jobs, which rely more on experience and skills than formal education.

What are the key skills and qualifications needed to thrive as a Utilization Manager, and why are they important?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What is the highest paying job in healthcare management?

The highest paying roles in healthcare management include Chief Executive Officers (CEOs) of hospitals and health systems, with salaries often exceeding $200,000 annually. Other high-paying positions include Chief Financial Officers (CFOs) and Chief Operating Officers (COOs), who oversee organizational strategy and operations, typically earning six-figure salaries. These roles require extensive experience, advanced degrees, and strong leadership skills.

What are some common challenges faced by Utilization Managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What Is a Utilization Manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative skills and knowledge of medical terminology. It provides experience in patient interaction, scheduling, and office management, which can serve as a stepping stone to more advanced healthcare roles. However, career advancement may require additional certifications or education.
More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Michigan? The most popular types of Utilization jobs in Michigan are:
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What job categories do people searching Utilization Manager jobs in Michigan look for? The top searched job categories for Utilization Manager jobs in Michigan are:
What cities in Michigan are hiring for Utilization Manager jobs? Cities in Michigan with the most Utilization Manager job openings:
What are popular job titles related to Utilization Manager jobs in MI? For Utilization Manager jobs in MI, the most frequently searched job titles are:
Utilization Manager jobs near you

Utilization Review Nurse Case Manager

Accident Fund Holdings, Inc.

Lansing, MI • On-site

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Job Description
The Utilization Review Nurse is responsible for applying medical knowledge, judgment, jurisdictional rules, and medical treatment guidelines to review workers' compensation medical necessity reviews. The Utilization Review (UR) Nurse engages with physicians, peer reviewers and collaborates with claim handlers to determine appropriate treatment decisions. The UR Nurse must be able to demonstrate and be accountable for the standards of practice, policies and procedures, quality assurance, and the goals of the organization. Also, review treatment of claimants through the workers' compensation system based on the individual's diagnosis, and jurisdictional regulations.
  • Review medical records and treatment plans to determine medical necessity and appropriateness of medical treatment based upon established guidelines, and jurisdictional rules.
  • Conduct prospective, concurrent, and retrospective medical necessity reviews.
  • Apply standardized and appropriate clinical guidelines and document claim file to justify treatment approvals.
  • Issue pre authorizations for procedures, diagnostic tests, therapies, and equipment.
  • Collaborate with physicians and healthcare providers to clarify treatment requests.
  • Communicate with claims handlers regarding treatment decisions, utilization trends, and determinations.
  • Ensure UR processes comply with state workers' compensation guidelines and regulatory bodies.
  • Maintain timely and accurate documentation that complies with regulatory and URAC requirements.
  • Stay updated on changes in healthcare policies and workers' compensation rules.
  • Prepare and submit clinical appeals when treatment requests are denied, supporting medical necessity with proper documentation.
EDUCATION
  • Registered nurse license active and unrestricted required.
  • Bachelor's degree in nursing (BSN) preferred. Compact and or multiple state RN licenses, or the ability to obtain additional licenses.
EXPERIENCE
  • Five (5) years of active patient or clinical care experience as a Registered Nurse is required.
  • Three (3) years workers compensation case management/utilization review, occupational health, rehabilitation or insurance experience preferred.
QUALIFICATIONS
  • Excellent oral and written communication skills.
  • Demonstrated leadership and project management abilities.
  • Ability and proficiency in the use of computers and Company standard software specific to position, including Microsoft Office products.
  • Strong clinical assessment, critical thinking, and communication skills.
  • Expertise in evidenced based guidelines.
  • Ability to analyze utilization data and identify trends.
  • Knowledge of clinical care and jurisdictional requirements.
  • Demonstrates the ability to be organized and efficient in prioritizing and managing assignments with minimal oversight and direction.
  • Demonstrates use of critical thinking, attention to detail, sound clinical judgement and assessment for decision making.
  • Demonstrates courteous, professional demeanor, ability to work collaboratively within a team and independently.
  • Strong working knowledge of workers' compensation laws.
  • Must possess strong negotiation skills and decision-making ability.
  • Attention to detail and analytical skills required.
  • Ability to exercise good judgement in evaluating and determining appropriateness of various actions within the process of workers compensation claims.
  • Ability to make competent, independent decisions and maintain confidentially where appropriate.
    PAY RANGE:
    Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not the standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $73,600 and $123,200.
    We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
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  • #AFG

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