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

KENT POWER INC

Rental Coordinator

Rockford, MI · On-site

$15 - $19.75/hr

This role serves as a critical link between field operations, project management, vendors, and ... Monitor utilization to reduce unnecessary rental time and identify opportunities for cost savings

Nestle

Continuous Improvement Specialist

Fremont, MI · On-site

$64K - $82K/yr

... Stakeholder Management, Loss Intelligence, etc.) Accountable for FI pillar and Industrial ... labor utilization studies, data reliability, SAP BOM/Master Data, Planning Rate Reviews, Asset ...

Dicastal North America

Training Technician

Greenville, MI

$40K - $52K/yr

Manage employee development through utilization of a custom needs-based training plan and employee ... Review and tracking of Department Training Matrix * 30 Day New Hire training form tracking and ...

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

Utilization Review Manager information

See Morley, MI salary details

$33.9K

$79.2K

$145.8K

How much do utilization review manager jobs pay per year?

As of Sep 1, 2026, the average yearly pay for utilization review manager in Morley, MI is $79,194.00, according to ZipRecruiter salary data. Most workers in this role earn between $51,800.00 and $95,300.00 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 cities near Morley, MI are hiring for Utilization Review Manager jobs?

Cities near Morley, MI with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you

RN Field Case Manager

Hope At Home Health Care

Mount Pleasant, MI • On-site

$100K/yr

Full-time

Medical

Re-posted 11 days ago

Job description

We are looking for a compassionate RN to join our growing team! The right candidate has a can-do attitude, a friendly demeanor, excellent interpersonal skills, and the ability to provide medical support to our clients in their homes.

WHY BE A FULL-TIME RN WITH HOPE AT HOME...

  • Earn upwards of $100k per year (based on full-time hours & must be able to drive to referrals within our service area)!!!
  • Provide care in Oakland and Wayne County, MI
  • Flexible schedules (work days, nights, evenings, weekends - we'll work around your needs)!!!
  • Benefits, pre-tax health insurance, and FSAs available (for full-time employees)!!!

So become a part of the Hope At Home Family and apply TODAY (serious applicants only)!

We currently have a position available for an experienced Home Health Care Registered Nurse! An RN with ICU, PICC Line, Wound Care, and Infusion experience is greatly preferred.

The corporate office is located in Southfield, MI and the individual will provide RN support throughout our service area within the Tri-County area (Oakland, Macomb & Wayne).

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their place of residence. This is performed in accordance with physician orders and plan of care under the direction and supervision of the Clinical Manager/Nursing Supervisor.

QUALIFICATIONS:

  • Graduate of an approved school of professional nursing and currently licensed in the state of Michigan
  • One year of nursing experience
  • Kinnser - EMR experience preferred
  • Home Healthcare experience preferred
  • Experience in wound vac, PICC line and mediport care, preferred
  • Pediatric experience, desired

RESPONSIBILITIES:

  • Provides services in accordance with the plan of care.
  • Makes the initial evaluation visit and regularly reevaluates the patient's nursing needs.
  • Initiates the plan of care and necessary revisions.
  • Provides those services requiring substantial specialized nursing skills.
  • Initiates appropriate preventive and rehabilitative nursing procedures.
  • Prepares clinical and progress notes for each patient visit and summaries of care conferences on his/her patients in a timely manner as per Agency policy.
  • Coordinates services.
  • Inform personnel of changes in the condition and needs of the patient.
  • Counsels the patient and family/significant others in meeting nursing and related needs.
  • Participates in and presents in-service programs.
  • Understands and adheres to established Agency policies and procedures.
  • Processes orders and notifies physician of patient needs and changes in condition. Completes certification/recertification orders and discharge summaries.
  • Determines the amount and type of nursing needed by each individual patient.
  • Refers to Physical Therapist, Speech Language Pathologist, Occupational Therapist and Medical Social Worker those patients requiring their specialized skills.
  • Supervises and teaches other nursing personnel.
  • Conducts patient care conferences on patients assigned to his/her care.
  • Participates in peer review and performance improvement as assigned.
  • Participates in utilization review of medical records as assigned.
  • Gives total patient care as needed.
  • Takes on-call duty nights, weekends and holidays, as assigned.
  • Completes and submits OASIS assessments, reassessments, transfers, resumptions of care, discharges and significant change in condition in accordance with Agency defined time frames.
  • Appropriately utilizes ICD-10 codes.

WORKING ENVIRONMENT:
Works indoors in Agency office and patient homes and travels to/from patient homes.

HOPE At Home Health Care is a full service home care agency dedicated to helping people excel in the comfort of their home. We offer Medicare certified skilled services. Whether you are recovering from injury or illness, or simply want to reinvigorate your mobility and health, HOPE At Home Health Care has a solution for you.

We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.