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Utilization Manager Jobs in Fenton, MI (NOW HIRING)

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 ...

TH Medical

Director - Case Management

Detroit, MI

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

Henry Ford Health

Physician Advisor (IPAS)

Troy, MI

Working collaboratively with medical staff leadership, resident physicians, case management, social services, and utilization management teams, you will develop and implement strategies that enhance ...

Healthcare Support Staffing

Care Review Clinician

Troy, MI · On-site

$33 - $37/hr

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

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All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Fenton, MI

Utilization Manager information

See Fenton, MI salary details

$35.2K

$82.2K

$151.2K

How much do utilization manager jobs pay per year?

As of Sep 7, 2026, the average yearly pay for utilization manager in Fenton, MI is $82,156.00, according to ZipRecruiter salary data. Most workers in this role earn between $53,700.00 and $98,800.00 per year, depending on experience, location, and employer.

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 are the key skills and qualifications needed to thrive as a utilization manager?

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 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 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.

More about Utilization Manager jobs

What job categories do people searching Utilization Manager jobs in Fenton, MI look for?

The top searched job categories for Utilization Manager jobs in Fenton, MI are:

What cities near Fenton, MI are hiring for Utilization Manager jobs?

Cities near Fenton, MI with the most Utilization Manager job openings:

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Fenton, MI as of August 2026, with employment types broken down into 84% Full Time, 12% Part Time, 1% Temporary, 2% Contract, and 1% Nights. Highlights an 80% Physical, 2% Hybrid, and 18% Remote job distribution, with an average salary of $82,156 per year, or $39.5 per hour.

RN Care Coordinator

Corewell Health

Farmington Hills, MI • On-site

Part-time

Medical, Retirement

Re-posted 2 days ago

Key responsibilities

  • Integrates cost, quality, and utilization to facilitate patient admission, stay, and discharge.

  • Manages a caseload of patients by coordinating utilization management, care, and discharge planning during hospitalization.

  • Communicates with payers, patients, families, physicians, and care providers to facilitate care coordination and smooth transitions.

Corewell Health rating

6.9

Company rating: 6.9 out of 10

Based on 783 frontline employees who took The Breakroom Quiz

453rd of 898 rated healthcare providers

Job description

PART TIME- 20 hours a week.
Scope of work
Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or continued stay based on medical necessity. The overall goal of the position is to enhance the quality of patient care and engagement, to promote continuity of care and cost effectiveness through the integration and functions of utilization management, and/or care coordination, discharge planning, and appropriate care transitions. Has accountability for the care coordination and discharge planning of all hospitalized patients.
  • Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning).
  • Responsible for managing a case load of patients that includes facilitating utilization management, and/or care coordination during the patient's stay, planning and expediting plans for safe and effective discharge and transition to the appropriate level of care and setting needed after hospitalization. Coordinating care by considering all patient's needs.
  • Uses critical thinking and effective judgment to determine alternative courses of care. Judiciously uses tools designed to expedite care while being cost effective. Actively participates in readmission initiatives and strategies to maximize patient flow and appropriate resource utilization. Works collaboratively on processes to provide effective transition for patients utilizing hospital outpatient, observation or inpatient services.
  • May review cases for medical necessity, uses InterQual and/or other UR/UM Committee-approved medical necessity screening criteria, when appropriate. Works collaboratively with departmental, revenue cycle, and clinical appeals staff, physicians, and payers to obtain authorization for care and appropriate reimbursement. Determines and assures appropriate status and level of care. Uses defined resources to guide decisions, including Medical Director Care Management, Physician Advisors, and management staff.
  • Routinely communicates with payers, patients/family caregivers, physicians, the interdisciplinary team, post-acute and community-based care providers to facilitate coordination of care and to enhance a seamless transition from hospital setting to the appropriate alternative level of care.
  • Seeks out information and resources to apply creative problem solving for complex discharge/transition planning, quality of care, and utilization management issues. Provides notification and communication to patients/families regarding coverage for hospital and post-acute services, in accordance with CMS regulations.
  • Documents utilization reviews, utilization management actions, care management assessment(s), care plan, discharge plan, and interventions, according to policies, procedures, and regulatory, contractual, and legal requirements. Acts proactively to see that hospital resources are utilized appropriately.
  • Works collaboratively with other departments to define areas of hospital inefficiency and participates in improvement projects.

Qualifications
  • Required Bachelor's Degree Graduate of an accredited school of nursing.
  • Required Will consider non-BSN RN if actively pursuing a Bachelors degree in nursing with completion within 2 years of hire.

  • 2 years of relevant experience Minimum two years' experience in the acute care setting. Required
  • 3 years of relevant experience Three to five years' experience in care management, utilization review, home care and/or discharge planning. Preferred

  • Registered Nurse (RN) - State of Michigan Upon Hire required
  • CRT-At least one Certification from preferred list - UNKNOWN Unknown Upon Hire required
  • Basic Life Support (BLS) - AHA American Heart Association preferred Or
  • Basic Life Support (BLS) - ARC American Red Cross preferred
  • Case Manager, Certified (CCM) - CCMC Commission for Case Manager Certification Upon Hire preferred

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 - Farmington Hills Hospital- 28050 Grand River Ave - Farmington Hills
Department Name
Care Management - Farmington Hills Hosp
Employment Type
Part time
Shift
Day (United States of America)
Weekly Scheduled Hours
20
Hours of Work
8:00am to 4:30pm
Days Worked
Variable
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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