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Utilization Review Np Jobs in Michigan (NOW HIRING)

Trinity Health

NP/PA Surgery - Urology

Ann Arbor, MI · On-site

$106K - $137K/yr

... utilization review processes. In partnership with the supervising physician the NP/PA evaluates care based on quality and core measures, access and cost effectiveness. The NP/PA contributes to ...

Trinity Health

NP/PA Surgery - Urology

Ann Arbor, MI · On-site

$106K - $137K/yr

... utilization review processes. In partnership with the supervising physician the NP/PA evaluates care based on quality and core measures, access and cost effectiveness. The NP/PA contributes to ...

Trinity Health

NP/PA - Vascular Surgery

Ann Arbor, MI · On-site

$106K - $137K/yr

... utilization review processes. In partnership with the supervising physician, the NP/PA evaluates care based on quality and core measures, access and cost effectiveness. The NP/PA contributes to ...

Trinity Health

NP/PA - Vascular Surgery

Ann Arbor, MI · On-site

$106K - $137K/yr

... utilization review processes. In partnership with the supervising physician, the NP/PA evaluates care based on quality and core measures, access and cost effectiveness. The NP/PA contributes to ...

PACE Southeast Michigan

Nurse Practitioner

Westland, MI · On-site

Nurse Practitioner The Nurse Practitioner (NP) is responsible for primary care to an assigned panel ... Utilization Management - Contributes to Utilization Management * Goals of Care: Facilitates ...

New

Pacesemi

Nurse Practitioner

Dearborn, MI · On-site

SUMMARY: The Nurse Practitioner (NP) is responsible for primary care to an assigned panel of ... Utilization Management - Contributes to Utilization Management * Goals of Care: Facilitates ...

PACE Southeast Michigan

Nurse Practitioner

Westland, MI · On-site

$125 - $150/hr

SUMMARY The Nurse Practitioner (NP) is responsible for primary care to an assigned panel of ... Conditions Utilization Management - Contributes to Utilization Management Goals of Care:

New

Heartland Hospice

Nurse Practitioner

Bad Axe, MI · On-site

... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...

Gentiva

MI · On-site

$125 - $150/hr

... care utilization. * Prescribe medications and treatments, including controlled substances, as ... Communicate findings, treatment plans, diagnostics, and medication reviews with IDG/IDT. * Provide ...

New

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Utilization Review Np information

What does a utilization review nurse practitioner do?

A Utilization Review Nurse Practitioner (NP) evaluates the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They review patient records, treatment plans, and insurance coverage to ensure that care meets established guidelines and regulatory requirements. Utilization Review NPs help coordinate care, prevent unnecessary procedures, and support cost-effective healthcare delivery while ensuring patient safety and quality outcomes.

What are some common challenges utilization review nurse practitioners face when collaborating with healthcare providers and insurance companies?

Utilization Review Nurse Practitioners often navigate the challenge of balancing patient advocacy with payer requirements. They must effectively communicate clinical justifications to both healthcare providers and insurance representatives, sometimes mediating disagreements over the necessity of certain treatments or hospital stays. Staying up-to-date with ever-changing insurance guidelines and ensuring timely documentation can also be demanding, but strong organizational and interpersonal skills help facilitate smooth collaboration and successful patient outcomes.

What are the key skills and qualifications needed to thrive as a utilization review nurse practitioner, and why are they important?

To thrive as a Utilization Review Nurse Practitioner (NP), you need expert clinical judgment, a strong understanding of healthcare regulations, and advanced assessment skills, typically supported by an active NP license and clinical experience. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance guidelines such as Medicare and Medicaid are commonly required. Excellent communication, attention to detail, and critical thinking are vital soft skills for effective case evaluations and collaboration with providers. These competencies ensure accurate, efficient reviews that support quality care, compliance, and cost-effective treatment decisions.

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

AspectUtilization Review NpUtilization Review Nurse
CredentialsMaster's degree in Nursing, Nurse Practitioner certification, state licensureRegistered Nurse (RN) license, possibly with certification in utilization review
Work EnvironmentHealthcare facilities, insurance companies, utilization review organizationsHospitals, insurance companies, outpatient clinics
Job ResponsibilitiesAssess medical necessity, authorize treatments, make clinical decisions, often with greater autonomyReview medical records, support authorization processes, follow established guidelines

Utilization Review NPs typically have advanced clinical training and greater decision-making authority compared to Utilization Review Nurses. Both roles focus on evaluating medical necessity, but NPs often perform more complex assessments and can make independent recommendations, whereas nurses support the review process under supervision or guidelines.

What are popular job titles related to Utilization Review Np jobs in Michigan?

For Utilization Review Np jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching Utilization Review Np jobs in Michigan look for?

The top searched job categories for Utilization Review Np jobs in Michigan are:

What cities in Michigan are hiring for Utilization Review Np jobs?

Cities in Michigan with the most Utilization Review Np job openings:

Utilization Review Np jobs near you
Infographic showing various Utilization Review Np job openings in Michigan as of August 2026, with employment types broken down into 80% Full Time, and 20% Contract. Highlights an 80% In-person, and 20% Remote job distribution.

NP/PA Surgery - Urology

Trinity Health

Ann Arbor, MI • On-site

$106K - $137K/yr

Part-time

Re-posted 18 days ago

Trinity Health rating

6.6

Company rating: 6.6 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

573rd of 898 rated healthcare providers

Job description

Employment Type:
Part timeShift:
Description:
The Urology NP/PA provides health care services under the direction of collaborating Urology surgeons under the direction of Advanced Practice Professional team (APP). Under the direction of the surgeon and APP team the NP/PA is responsible for coordinating the health care plan for the assigned patient population by collaborating with consulting physicians and health care professionals. The NP/PA carries out physician orders and maintains the continuum of care through the coordination and integration of all phases of patient care, guided by progress notes, consults, care plans, critical pathways, managed care guidelines, best practice protocols, evidenced based care, and the utilization review processes. In partnership with the supervising physician the NP/PA evaluates care based on quality and core measures, access and cost effectiveness. The NP/PA contributes to excellence in patient care by focusing on age specific, developmental and spiritual needs and serving as a role model in patient care, consulting, teaching, and leadership.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES
Clinical care for Urology patients: Formulates and implements medical and nursing plans of care for acute management of all Urology (inpatient, emergency department, and consult) patients with collaborating physicians. Assists with evaluation and triage of emergency room patients. Provides direct clinical services for Urology patients according to established protocols, using evidence-based practice and clinical practice standards, under the supervision of the collaborating physicians. Orders appropriate diagnostic and laboratory data under the direction of the supervising physician and communicates results to physicians and other health care providers. Assesses changes in patient status and institutes routine and emergency interventions to stabilize patients under the direction of the supervising physician and APP team. Documents plan of care and patient progress in medical records and narrative summaries. Evaluates and documents patient outcomes and revises the plan under the direction of collaborating physicians in association with other specialty consultants. Helps facilitates discharge planning along with patients, families, other members of the health care team and referral agencies.
REQUIRED EDUCATION, EXPERIENCE AND CERTIFICATION/LICENSURE
NP Education:
Master's Degree in clinical nursing from an accredited Acute Care Nurse Practitioner Program with emphasis on area of certification/licensure.
NP Licensure:
Current Registered Nurse and Nurse Practitioner license in the State of Michigan.
PA Education:
Requires graduation from an ARC-PA accredited PA program.
PA Licensure:
Current License/Certification as Physician Assistant with the State of Michigan.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

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About Trinity Health

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Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US

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