ZipRecruiter

Log In

1

Utilization Review Rn Jobs in Washington, 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 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 INC

Registered Nurse

Troy, MI

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

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 ...

Spectrum 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 ...

Hope At Home Health Care

RN Field Case Manager

Clarkston, MI · On-site

$79K - $101K/yr

WHY BE PRN RN WITH HOPE AT HOME... * Unlimited earning potential!!! * Provide care in Oakland ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

Hope At Home Health Care

RN Field Case Manager

Pontiac, MI · On-site

$77K - $98K/yr

WHY BE PRN RN WITH HOPE AT HOME... * Unlimited earning potential!!! * Provide care in Oakland ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

Hope At Home Health Care

RN Field Case Manager

Clarkston, MI · On-site

$79K - $101K/yr

WHY BE PRN RN WITH HOPE AT HOME... * Unlimited earning potential!!! * Provide care in Oakland ... Participates in utilization review of medical records as assigned. * Gives total patient care as ...

previous pagenext page

Showing results 21-40

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

Utilization Review Rn information

See Washington, MI salary details

$19

$39

$63

How much do utilization review rn jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for utilization review rn in Washington, MI is $39.21, according to ZipRecruiter salary data. Most workers in this role earn between $31.01 and $45.05 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 popular job titles related to Utilization Review Rn jobs in Washington, MI?

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

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

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

Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Washington, MI as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 15% Part Time, 4% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $81,558 per year, or $39.2 per hour.

RN Precertification Analyst

OpTech LLC

Detroit, MI • On-site

Full-time

Retirement

Posted 7 days ago

Job description

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 and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through the health care continuum including member outreach assessments.
Requirements:
  • RN - unrestricted Michigan Registered Nurse license required
  • 2-4 years of clinical experience - acute patient care, discharge planning, case management, and utilization review
  • Clinical experience in ICU, ER, or medical surgical unit preferred .
  • Utilization management experience preferred
  • 1 year health insurance plan experience or managed care environment preferred.
  • Computer - MS Office, Type 35+WPM, Dual monitors, multiple systems
  • Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.

Why work with us? We are a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work with us you'll have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! We are an EOE, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. https://www.optechus.com/eeo_self_identification/

Apply