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

OpTech LLC

RN Precertification Analyst

Detroit, MI · On-site

Detroit, MI Registered Nurse (RN) Contract We are seeking a Michigan RN - Remote Utilization Management: Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory ...

OpTech

RN Utilization Management

Detroit, MI · On-site

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ... RN license * 2 + yr clinical experience - acute care * Utilization Management experience/role

OpTech LLC

RN Utilization Management

Detroit, MI · On-site

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ... RN license * 2 + yr clinical experience - acute care * Utilization Management experience/role

Integrated Resources

Registered Nurse

Troy, MI · On-site

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

Corewell Health

RN Care Coordinator

Northville, MI · On-site

Identifies patients that need care management services (i.e. utilization review; care coordination ... Required Will consider non-BSN RN if actively pursuing a Bachelors degree in nursing with ...

Integrated Resources INC

Registered Nurse

Troy, MI · On-site

... utilization review and other utilization management activities aimed at providing Healthcare ... Completion of an accredited Registered Nursing program. (a combination of experience and education ...

KYYBA

RN Review Analyst

Detroit, MI · On-site

$36 - $38/hr

Remote RN Review Analyst Location: 100% Remote Duration: 12+ Months License Required: Michigan ... utilization management preferred. CERTIFICATES, LICENSES, REGISTRATIONS 1. Registered Nurse with ...

Corewell Health

RN Care Coordinator

Royal Oak, MI · On-site

... utilization review; care coordination; and/or discharge/transition planning). 2. Responsible for ... Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing with ...

Corewell Health

RN Care Coordinator

Farmington, MI · On-site

Identifies patients that need care management services (i.e. utilization review; care coordination ... Required Will consider non-BSN RN if actively pursuing a Bachelors degree in nursing with ...

Spectrum Health

RN Care Coordinator

Royal Oak, MI

... utilization review; care coordination; and/or discharge/transition planning). 2. Responsible for ... Preferred Will consider non-BSN RN if actively pursuing a bachelor's degree in nursing with ...

Corewell Health

RN Care Coordinator

Dearborn, MI · On-site

Identifies patients that need care management services (i.e. utilization review; care coordination ... Required Will consider non-BSN RN if actively pursuing a Bachelors degree in nursing with ...

Spectrum Health

RN Care Coordinator

Dearborn, MI

Identifies patients that need care management services (i.e. utilization review; care coordination ... Required Will consider non-BSN RN if actively pursuing a Bachelors degree in nursing with ...

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

Utilization Review Rn information

See Detroit, MI salary details

$19

$38

$63

How much do utilization review rn jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for utilization review rn in Detroit, MI is $38.69, according to ZipRecruiter salary data. Most workers in this role earn between $30.58 and $44.42 per hour, depending on experience, location, and employer.

What is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

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

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Detroit, MI?

The most popular types of Utilization Review Rn jobs in Detroit, MI are:

What are popular job titles related to Utilization Review Rn jobs in Detroit, MI?

For Utilization Review Rn jobs in Detroit, MI, the most frequently searched job titles are:

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The top searched job categories for Utilization Review Rn jobs in Detroit, MI are:

What cities near Detroit, MI are hiring for Utilization Review Rn jobs?

Cities near Detroit, MI with the most Utilization Review Rn job openings:

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Detroit, MI as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 2% Hybrid, and 11% Remote job distribution, with an average salary of $80,470 per year, or $38.7 per hour.

Care Review Clinician

Healthcare Support Staffing

Troy, MI • On-site

Full-time

Re-posted yesterday

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

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:  

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

Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long Term Care

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


Hours for this Position:

Mon-Fri 8:30am-5pm


Qualifications



Qualifications/ Requirements: 

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

Interqual experience (at least one year)

Registered Nurse in the state of Michigan


Additional Information

Interested in hearing more about this great opportunity? Reach out to Michael Grifon at HealthCare Support Staffing for IMMEDIATE, SAME-DAY consideration. Interviews are being held THIS WEEK and immediate offers will be extended. Click I'M INTERESTED for more information; we look forward to hearing for you!

Healthcare Support logo

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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