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

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

Spectrum Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

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 ...

Healthcare Support Staffing

Care Review Clinician

Troy, MI · On-site

$33 - $37/hr

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Detroit, MI

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 Sep 6, 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.

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 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 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 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.

How much does a utilization review manager make?

A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.

Is utilization review manager a stressful job?

Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.

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.

Care Review Clinician - UR RN

Healthcare Support Staffing

Troy, MI • On-site

Full-time

Re-posted 11 days ago

Job description

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Job Description:

Are you an experienced Registered Nurse looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!


Daily Responsibilities:  

Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team

- Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.

- Providing utilization review for the Medicaid and Medicare line of business. Primarily inpatient, skilled nurses facilities, rehab, behavioral health, and home healthcare


Qualifications

Hours for this Position:

Mon-Fri 8:30am-5pm


Advantages of this Opportunity: 

Competitive salary, negotiable based on relevant experience

Acquire new skills and broaden your experience / expertise

Fun and positive work environment


Qualifications/ Requirements: 

Utilization Review background in either Managed Care of Provider environment (at least one year)

RN License in Michigan

Interqual experience (at least one year)

Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management


Additional Information
Interested in hearing more about this great opportunity?

If you are interested in applying to this position, please click Apply Now and email your resume to Michael Grifon.


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About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

Social media

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