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Utilization Review Case Manager Jobs in Michigan

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

Job Summary Our client is seeking a Utilization Review Nurse to manage the full lifecycle of ... Manage the full lifecycle of IRO cases from intake through final case closure. * Review incoming ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... This includes the implementation of case management scenarios, consulting with all services to ...

Universal Hospital Services Inc.

$90 - $115/hr

... Utilization Review Manager. Position Description The Utilization Manager is responsible for ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Utilization Review Manager

Grand Rapids, MI

... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Utilization Review Manager

Grand Rapids, MI

... Utilization Review Manager. Position Description: The Utilization Manager is responsible for ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Manager of Utilization Review

Saint Johns, MI · On-site

Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Manager of Utilization Review

Saint Johns, MI

Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... This includes the implementation of case management scenarios, consulting with all services to ...

UHS

Manager of Utilization Review

Saint Johns, MI · On-site

Cedar Creek Hospital Description The Manager of Utilization Review is responsible for managing and ... This includes the implementation of case management scenarios, consulting with all services to ...

Henry Ford Health System

Case Manager-SW Afternoons

Detroit, MI · On-site

$19.75 - $25.50/hr

Knowledge of computers, Electronic Health Records, data base systems and utilization review/case management documentation systems. Desire to work collaboratively and proactively with healthcare teams ...

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All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Michigan

Utilization Review Case Manager information

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$14

$31

$52

How much do utilization review case manager jobs pay per hour?

As of Aug 31, 2026, the average hourly pay for utilization review case manager in Michigan is $31.80, according to ZipRecruiter salary data. Most workers in this role earn between $25.77 and $33.51 per hour, depending on experience, location, and employer.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.

What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Review Case Manager jobs in Michigan?

For Utilization Review Case Manager jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Utilization Review Case Manager jobs in Michigan look for?

The top searched job categories for Utilization Review Case Manager jobs in Michigan are:

What cities in Michigan are hiring for Utilization Review Case Manager jobs?

Cities in Michigan with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Michigan as of August 2026, with employment types broken down into 56% Full Time, and 44% Contract. Highlights an 100% In-person job distribution, with an average salary of $66,146 per year, or $31.8 per hour.

Utilization Review Nurse

Medix

Southfield, MI • On-site

$42 - $46/hr

Part-time

Medical, Dental, Vision, Retirement

Posted 29 days ago

Job description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
Our client is seeking a Utilization Review Nurse to manage the full lifecycle of Independent Review Organization (IRO) cases. The primary responsibilities include reviewing clinical documentation, performing quality assurance on physician reports, and collaborating with various teams to ensure accurate and timely case handling.
Key Responsibilities
  • Manage the full lifecycle of IRO cases from intake through final case closure.
  • Review incoming clinical documentation, verify completeness, and prepare concise case summaries for physician reviewers.
  • Coordinate and route cases to the appropriate physician specialty while managing requests for additional medical records.
  • Perform quality assurance on physician reports to ensure accuracy, clarity, completeness, and defensibility.
  • Monitor regulatory deadlines and case status to ensure timely, compliant case completion.
  • Maintain accurate case tracking and documentation within internal systems and state IRO programs.
  • Collaborate with physicians, clients, and internal teams to resolve documentation gaps and support case progression.
  • Contribute to workflow improvements, new state program implementation, and process optimization as the organization grows.

Qualifications
  • Active RN license and BSN required.
  • Experience with Independent Review Organizations (IROs), or Utilization Review/Appeals within a Health Plan or TPA.
  • Strong clinical documentation review, case summary writing, and QA skills.
  • Excellent written communication with exceptional attention to detail.
  • Ability to independently manage multiple cases while meeting regulatory timelines.

Skills
  • Technical: Proficiency in clinical documentation review and case summary writing.
  • Soft: Strong written communication, attention to detail, and independent case management skills.

Benefits
  • Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
  • Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
  • 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
  • Short Term Disability Insurance.
  • Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
* As a job position within our Care Management division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, access and handling of patient medical records, providing medical care inside a patient's residential address, driving, prescription and other drug access and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
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About Medix Staffing Solutions

Sourced by ZipRecruiter

Since 2001, we’ve been dedicated to helping you achieve your goals. Medix was created to become a leading provider of workforce solutions for clients and candidates across the healthcare and life sciences industries. Today, we are that leader. Headquartered in Chicago, we have 23 offices across the United States, and staff talent around the world. Medix is committed to fulfilling our core purpose as an organization: to positively impact the lives of our talent, clients, and teammates through employment, philanthropy, and opportunity. The combination of purpose and values has nurtured our thriving culture that encourages our internal team to excel at work and in everyday life.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Chicago, IL, US

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