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Utilization Review Management Jobs in Michigan (NOW HIRING)

Trinityhealth

Case Manager

Livonia, MI

$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

$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 ...

Dane Street, LLC

MI · On-site

$324K - $366K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

Dane Street, LLC

Board-Certified Rheumatologist

Portage, MI · On-site

$262K - $339K/yr

Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams

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Utilization Review Management information

See Michigan salary details

$13

$27

$46

How much do utilization review management jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for utilization review management in Michigan is $27.84, according to ZipRecruiter salary data. Most workers in this role earn between $19.47 and $35.38 per hour, depending on experience, location, and employer.

What are the job titles for utilization review management?

Job titles in utilization review management include Utilization Review Nurse, Utilization Review Coordinator, Utilization Review Nurse Case Manager, and Utilization Review Supervisor. These roles typically involve assessing medical necessity, reviewing patient records, and ensuring compliance with healthcare policies, often requiring certification such as the Certified Professional in Healthcare Quality (CPHQ).

What is the difference between Utilization Review Management vs Utilization Review Nurse?

AspectUtilization Review ManagementUtilization Review Nurse
CredentialsTypically requires a healthcare management or related certification, sometimes a nursing backgroundRegistered Nurse (RN) license, often with additional utilization review certification
Work EnvironmentOffice-based, administrative setting, collaborating with healthcare providers and insurance companiesClinical setting, reviewing patient charts, and making utilization decisions
Employer & IndustryHealth insurance companies, managed care organizations, healthcare administratorsHospitals, insurance companies, healthcare facilities

Utilization Review Management professionals focus on overseeing review processes, policy compliance, and administrative tasks, while Utilization Review Nurses conduct clinical assessments to determine appropriate care. Both roles are essential in healthcare utilization management but differ in responsibilities and work environment.

What are some common challenges faced by professionals in utilization review management, and how can they be addressed?

Professionals in Utilization Review Management often encounter challenges such as balancing regulatory compliance with patient advocacy and managing high caseloads under tight deadlines. Navigating complex insurance policies and ensuring timely communication between healthcare providers and payers can be demanding. Staying organized, leveraging technology for workflow management, and participating in ongoing training can help address these challenges. Additionally, strong collaboration with interdisciplinary teams ensures more effective and efficient utilization review processes.

What is utilization review management?

Utilization Review Management is a process used in healthcare to evaluate the necessity, appropriateness, and efficiency of medical services, procedures, and facilities. Its primary goal is to ensure that patients receive appropriate care while preventing unnecessary or duplicative services. Utilization Review Management helps healthcare providers and insurance companies manage costs, maintain high-quality care, and comply with regulations. Professionals in this field often review patient records, coordinate with clinicians, and make recommendations about coverage or care plans.

What are the key skills and qualifications needed to thrive in utilization review management?

To thrive in Utilization Review Management, you need a solid background in healthcare, strong analytical skills, and often a clinical degree such as RN or LPN, with certification in utilization review or case management being highly beneficial. Familiarity with medical coding systems (ICD-10, CPT), electronic health records (EHRs), and utilization management software is typically required. Excellent communication, critical thinking, and negotiation skills help you collaborate with providers and payers while advocating for patient care. These competencies are vital for ensuring appropriate resource use, regulatory compliance, and optimal patient outcomes.
Utilization Review Management jobs near you
Infographic showing various Utilization Review Management job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 1% Temporary, and 4% Contract. Highlights an 91% Physical, 4% Hybrid, and 5% Remote job distribution, with an average salary of $57,905 per year, or $27.8 per hour.

Board Certified Pain Management Specialist (M.D, D.O.)

Dane Street

Detroit, MI • On-site

Other

Re-posted 13 days ago

Job description

Dane Street is expanding our physician panel! We are seeking a skilled and board-certified (Specialty) in (City, State) to join our team for Independent Medical Examinations (IMEs). This role offers flexible scheduling, allowing you to select or decline assignments based on your availability. Our physician panel comprises independent contract reviewers (1099) compensated on a per-case basis.

Dane Street is a national leader in Independent Medical Examinations (IMEs) and peer-review services, trusted by insurance carriers and organizations nationwide for objective, high-quality medical evaluations.

Key responsibilities

    • Thorough review of Medical Records
    • Perform in-person evaluations of patients with (specialty)  issues
    • Respond to clinical queries to support claims management
    • Deliver detailed IME reports within an expected turnaround time of 5 days

Requirements

    • Board-certification required.
    • Previous experience in performing IMEs is preferred.
    • Strong analytical skills and excellent communication abilities are a plus
    • If you are a dedicated (Specialty) looking for a flexible opportunity to apply your expertise in an IME capacity, we encourage you to apply.

Benefits

Benefits

  • Robust opportunity for supplemental income
  • Schedule flexibility and predictable work hours - You volume, and conduct exams based on your schedule availability
  • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions.
  • Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
  • Expanded credentials as an expert in Independent Medical Exams and physician advisor services
  • No-show fees and late cancellation fees are established to protect your time.
  • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal

Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery.

Apply