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Utilization Review Case Manager Jobs in Michigan

Henry Ford Health System

Case Manager-Social Worker

Detroit, MI · On-site

$21.50 - $28.25/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 ...

Henry Ford Health System

Case Manager-Social Worker

Detroit, MI · On-site

$21.50 - $28.25/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 ...

Henry Ford Health System

Case Manager-Social Worker

Detroit, MI · On-site

$21.50 - $28.25/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 ...

Trinityhealth

Case Manager

Livonia, MI · On-site

$18.75 - $24/hr

Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...

Trinity Health

Case Manager

Livonia, MI · On-site

$18.75 - $24/hr

Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. Current knowledge of third party payor ...

Trinity Health

Case Manager

Livonia, MI · On-site

$18.75 - $24/hr

Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...

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Utilization Review Case Manager information

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

As of Sep 2, 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 57% Full Time, and 43% Contract. Highlights an 100% In-person job distribution, with an average salary of $66,146 per year, or $31.8 per hour.

Case Manager-Social Worker

Henry Ford Health System

Detroit, MI

$21.50 - $28.25/hr

Full-time

Re-posted 24 days ago

Henry Ford Health rating

6.9

Company rating: 6.9 out of 10

Based on 572 frontline employees who took The Breakroom Quiz

455th of 898 rated healthcare providers

Job description

FULL TIME 40 HOURS, DAYS 8:00AM TO 4:30PM 

GENERAL SUMMARY: 

The Case Manager SW provides therapeutic intervention and social work services to patients and their families to enhance comprehensive, integrated, and uninterrupted care in the hospital and to facilitate continuity of care in the community. Demonstrates positive interpersonal communication with patients, families, visitors, and co-workers in accordance with organization and departmental policies and procedures.

EDUCATION/EXPERIENCE REQUIRED:

Master's degree in Social Work required. Three (3) years of clinical experience. Knowledge of social work practices, individuals, case recording, chart documentation, community referrals, and effective networking techniques to coordinate services for patient outside of the hospital is required. Familiarity with general medicine psychiatry, psychology and sociology and how social, familial, economic, and individual factors affect how an individual functions required. Knowledge of child and adult protection laws, state Medicaid guidelines, NASW code of ethics (professional standards), and confidentiality and privacy, as applicable to the area of specialty is desired. Ability to demonstrate knowledge and skills necessary to provide care appropriate to the patient population(s) served. Ability to demonstrate knowledge of the principles of growth and development over the life span and ability to assess data reflective of the patient's requirements relative to his or her population-specific and age-specific needs. Ability to make independent decision regarding clinical, psycho-social patient are and to provide input regarding the organization and functioning of the hospital unit required. Highly effective verbal and written communication skills are necessary to conduct successful counseling, social services, supervision of students, consultation with colleagues and documentation of patient counseling session. Strong collaboration, communication, and interpersonal skills. Excellent organization and time management skills. 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 and other hospital-based interdisciplinary teams. Knowledge of CMS, commercial payer requirements and hospital financial/ reimbursement processes desired. Excellent written/verbal communication skills, critical thinking skills, creative problem-solving skills, good organization, and planning skills. Must be self-directed, have the ability tolerate frequent interruption and work in a fast-paced work environment.

CERTIFICATIONS/LICENSURES REQUIRED:

Licensed Social Worker (LMSW) with a valid, unrestricted State of Michigan license. Certification in Case Management (CCM) by the Commission for Case Management Certification (CCMC) or Accredited Case Manager (ACM) by the American Case Management Association preferred.

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About Henry Ford Health

Sourced by ZipRecruiter

Henry Ford Health provides a full continuum of services from Primary and Preventative care, to Complex and Cpecialty care, Health Insurance, a full suite of home health offerings, Virtual care, Pharmacy, Eye care and other Healthcare retail. It is one of the Nation’s leading Academic Medical Centers, recognized for Clinical excellence in Cancer care, Cardiology and Cardiovascular Surgery, Neurology and Neurosurgery, Orthopedics and Sports medicine, and Multi organ transplants. Consistently ranked among the top five NIH funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of Health Professionals, Henry Ford Health trains more than 4,000 Medical students, Residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most Diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Detroit, MI, US

Year founded

1915

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