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Utilization Review Manager Jobs in Detroit, MI (NOW HIRING)

Medix

Utilization Review Nurse

Southfield, MI · On-site

$42 - $46/hr

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 ...

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Utilization Review Manager information

See Detroit, MI salary details

$35.7K

$83.3K

$153.3K

How much do utilization review manager jobs pay per year?

As of Aug 11, 2026, the average yearly pay for utilization review manager in Detroit, MI is $83,274.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,400.00 and $100,200.00 per year, depending on experience, location, and employer.

Is utilization review a stressful job?

Utilization review managers oversee the assessment of healthcare services to ensure appropriate and efficient care, which can involve high workloads and strict deadlines, leading to stress. The job requires strong organizational skills, attention to detail, and the ability to handle complex cases, which may contribute to job-related stress for some individuals.

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

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 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 the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.
What are the most commonly searched types of Utilization Review jobs in Detroit, MI? The most popular types of Utilization Review jobs in Detroit, MI are:
What are popular job titles related to Utilization Review Manager jobs in Detroit, MI? For Utilization Review Manager jobs in Detroit, MI, the most frequently searched job titles are:
What job categories do people searching Utilization Review Manager jobs in Detroit, MI look for? The top searched job categories for Utilization Review Manager jobs in Detroit, MI are:
What cities near Detroit, MI are hiring for Utilization Review Manager jobs? Cities near Detroit, MI with the most Utilization Review Manager job openings:
Utilization Review Manager jobs near you
Infographic showing various Utilization Review Manager job openings in Detroit, MI as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, 1% Contract, and 1% Nights. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $83,274 per year, or $40 per hour.

Utilization Review Manager

Acadia Healthcare

New Baltimore, MI • On-site

$25 - $35/hr

Full-time

Re-posted 24 days ago

Acadia Healthcare rating

6.2

Company rating: 6.2 out of 10

Based on 190 frontline employees who took The Breakroom Quiz

698th of 887 rated healthcare providers

Job description

Overview
Harbor Oaks Hospital is looking for a Utilization Review Manager to join our team!
Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI.
Non-Exempt Position
Full Time Position
Monday - Friday - Day Shift
Rate of Pay: $25.00 - $35.00 per hour (based on experience)
Responsibilities
PURPOSE STATEMENT:
Monitor utilization of services and optimize reimbursement for the facility while maximizing use of the patient's provider benefits for their needs.
ESSENTIAL FUNCTIONS:
  • Provide consultation and guidance regarding admissions and patient length of stay to a variety of payers.
  • Secure authorizations with insurance companies for inpatient treatment and continue to obtain authorizations for duration of patient stay.
  • Evaluate the utilization program for compliance with regulations, policies and procedures.
  • Review clinical documentation from denied stays against criteria to determine if documentation is adequate for requested treatment.
  • Provide staff management to including hiring, development, training, performance management and communication to ensure effective and efficient department operation.

OTHER FUNCTIONS:
  • Perform other functions and tasks as assigned.

Qualifications
LICENSES/DESIGNATIONS/CERTIFICATIONS:
  • If applicable, current licensure as an LPN or RN or LPC, or LMSW or LLMSW within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility).
  • First aid may be required based on state or facility requirements.

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About Acadia Healthcare

Sourced by ZipRecruiter

Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Franklin, TN, US

Year founded

2005

Social media

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