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Utilization Review Manager Jobs in Michigan (NOW HIRING)

Trinity Health

ECT Coordinator

Livonia, MI · On-site

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES MAY INCLUDE 1. Provides leadership and expertise for utilization management processes. 2. Completes the UR review and obtains authorization on retrospective ...

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Utilization Review Manager information

See Michigan salary details

$34K

$79.3K

$146K

How much do utilization review manager jobs pay per year?

As of Jun 15, 2026, the average yearly pay for utilization review 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 jobs pay $2000 a day?

Utilization Review Managers typically do not earn $2000 a day; such high daily rates are more common in specialized consulting, executive roles, or highly paid medical professionals. Most jobs with daily earnings of this level require extensive experience, certifications, or work in high-demand industries like finance, law, or executive management.

What are some common challenges faced by Utilization Review Managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

What job makes $10,000 a month without a degree?

A Utilization Review Manager can potentially earn around $10,000 per month, especially with extensive experience and certifications in healthcare management or medical review. These roles typically require strong analytical skills, knowledge of medical billing and coding, and the ability to oversee utilization review processes in healthcare settings. While a degree can be helpful, some professionals advance through experience and industry certifications such as Certified Professional in Healthcare Quality (CPHQ).

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

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What jobs in the US pay 300,000 a year?

Utilization Review Managers in healthcare or insurance industries can earn around $300,000 annually with extensive experience, advanced certifications, and leadership responsibilities. High-paying roles often require strong analytical skills, knowledge of medical billing and coding, and proficiency with healthcare management software. Executive-level positions in healthcare organizations may also reach or exceed this salary level.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a utilization review manager do?

A utilization review manager oversees the process of evaluating medical services to ensure they are necessary, appropriate, and cost-effective. They coordinate with healthcare providers, review patient records, and ensure compliance with insurance and regulatory standards, often using specialized software. This role requires strong analytical skills and knowledge of healthcare policies and insurance guidelines.
What are the most commonly searched types of Utilization Review jobs in Michigan? The most popular types of Utilization Review jobs in Michigan are:
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What job categories do people searching Utilization Review Manager jobs in Michigan look for? The top searched job categories for Utilization Review Manager jobs in Michigan are:
What cities in Michigan are hiring for Utilization Review Manager jobs? Cities in Michigan with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
RN Utilization Review Specialist

RN Utilization Review Specialist

Spectrum Health

Grand Rapids, MI • On-site

Full-time

Medical, Retirement

Posted 12 days ago

Job description

Scope of work:
Provides health information, interacts, and acts as a resource for providers for complex clinical situations to ensure appropriate use of preservice and concurrent acute medical and/or behavioral health care services. Assesses appropriateness of preservice and concurrent requests for admissions and continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. Makes recommendations and provides financial and utilization management (UM) information to other members of the care facilitation teams for work prioritization. Works closely with inpatient care facilitators, Medical Social Workers, home health agencies, and providers to move patients through the continuum appropriately. Medical necessity reviews for designated services are completed for all Priority Health plans.
  • Assesses and interprets clinical information and assists in case management of complex patient population, through use of independent judgment, mature problem solving skills, and guidelines for appropriateness of acute care setting upon admission and continued stay.
  • Ensure documentation and processes are consistent with regulatory standards
  • Communicates with physicians, medical social workers, and other hospital personnel concerning change in level of care on the medically complex patient population. Makes recommendations and discusses alternatives. Provides financial/DRG, UM, health information to other facilitation team members for work prioritization. Communicates and collaborates with physicians and members of the team to ensure continuity and coordination of services.
  • Documents any instances where services were delayed, inappropriate, refused, complicated, etc. for resource management functions.
  • Identifies quality indicators to facilitate process improvement and physician education.
  • Ensure members are authorized for the most appropriate level of care and services based on internal and external guidelines.
  • Collaborates with Medical Directors
Qualifications
  • Required Bachelor's Degree or equivalent Nursing or a health care related field;
  • 2 years of relevant experience acute care, clinical nursing, preferably multiple clinical settings, or related experience Required
  • 5 years of relevant experience Skills/knowledge/abilities typically gained through at least five years, post licensure, related experience in acute care, multiple clinical settings or behavioral health with utilization management ,discharge planning designing patient centered care plan or related work Required
  • Registered Nurse (RN) - State of Michigan Upon Hire required

    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 - Priority Health - 1231 E Beltline Ave NE - Grand Rapids

    Department Name

    Utilization Management - PH Managed Benefits

    Employment Type

    Full time

    Shift

    Day (United States of America)

    Weekly Scheduled Hours

    40

    Hours of Work

    8:00 am to 5:00 pm

    Days Worked

    Monday - Friday

    Weekend Frequency

    N/A

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    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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