Care Review Clinician II
Troy, MI ยท On-site
This is utilization review. Qualifications MCG experience (6-12 months of professional experience is sufficient. Computer Literate (Microsoft Office Suite Products - Word, Excel, and Outlook). Will ...
Care Review Clinician II
Troy, MI ยท On-site
This is utilization review. Qualifications MCG experience (6-12 months of professional experience is sufficient. Computer Literate (Microsoft Office Suite Products - Word, Excel, and Outlook). Will ...
Care Review Clinician
$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 ...
Care Review Clinician
$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 ...
Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI ยท On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts ... The scope of this position includes the review of clinical care and treatment plans for the SUD ...
Quick apply
Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI ยท On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts ... The scope of this position includes the review of clinical care and treatment plans for the SUD ...
RN-Clinical Review Analyst
Detroit, MI ยท On-site
$33 - $34/hr
Prefer utilization management experience Additional Qualifications: * Two (2) to three (3) years of ... review, etc. * Demonstrated clinical knowledge and experience relative to patient care and health ...
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RN-Clinical Review Analyst
Detroit, MI ยท On-site
$33 - $34/hr
Prefer utilization management experience Additional Qualifications: * Two (2) to three (3) years of ... review, etc. * Demonstrated clinical knowledge and experience relative to patient care and health ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and ... Improved timeliness of case reviews not meetingutilizationmanagement screening for inpatient ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and ... Improved timeliness of case reviews not meetingutilizationmanagement screening for inpatient ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and ... Improved timeliness of case reviews not meetingutilizationmanagement screening for inpatient ...
Corewell Health is expanding its Utilization Management team and is seeking a collaborative and ... Improved timeliness of case reviews not meetingutilizationmanagement screening for inpatient ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Improved timeliness of case reviews not meeting utilization management screening for inpatient criteria. * Improved management of concurrent utilization management denials. In addition, the Physician ...
Improved timeliness of case reviews not meeting utilization management screening for inpatient criteria. * Improved management of concurrent utilization management denials. In addition, the Physician ...
Improved timeliness of case reviews not meeting utilization management screening for inpatient criteria. * Improved management of concurrent utilization management denials. In addition, the Physician ...
Improved timeliness of case reviews not meeting utilization management screening for inpatient criteria. * Improved management of concurrent utilization management denials. In addition, the Physician ...
Medical Review Specialist- REMOTE (EST zone)
Southfield, MI ยท On-site
$48K - $55K/yr
Assesses appropriateness and duration of care provided, for possible utilization review. * Recommends independent medical evaluations (IME) to adjusters when necessary. * Act as a resource to other ...
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Medical Review Specialist- REMOTE (EST zone)
Southfield, MI ยท On-site
$48K - $55K/yr
Assesses appropriateness and duration of care provided, for possible utilization review. * Recommends independent medical evaluations (IME) to adjusters when necessary. * Act as a resource to other ...
Medical Review Specialist- REMOTE (EST zone)
Southfield, MI ยท On-site
$48K - $55K/yr
Assesses appropriateness and duration of care provided, for possible utilization review. * Recommends independent medical evaluations (IME) to adjusters when necessary. * Act as a resource to other ...
Quick apply
Medical Review Specialist- REMOTE (EST zone)
Southfield, MI ยท On-site
$48K - $55K/yr
Assesses appropriateness and duration of care provided, for possible utilization review. * Recommends independent medical evaluations (IME) to adjusters when necessary. * Act as a resource to other ...
Job Summary Under general direction and according to established policies and procedures, monitors patient care for quality assurance, utilization review and risk management activities. Determines ...
Job Summary Under general direction and according to established policies and procedures, monitors patient care for quality assurance, utilization review and risk management activities. Determines ...
RN Care Coordinator
Royal Oak, MI ยท On-site
Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning). * Responsible for managing a case load of patients that ...
RN Care Coordinator
Royal Oak, MI ยท On-site
Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning). * Responsible for managing a case load of patients that ...
Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or ...
Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or ...
RN Care Coordinator
Grosse Pointe, MI ยท On-site
Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or ...
RN Care Coordinator
Grosse Pointe, MI ยท On-site
Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of admission or ...
Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning). * Responsible for managing a case load of patients that ...
Identifies patients that need care management services (i.e. utilization review; care coordination; and/or discharge/transition planning). * Responsible for managing a case load of patients that ...
Scope of work Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of ...
Scope of work Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of ...
RN Care Coordinator
Royal Oak, MI ยท On-site
Scope of work Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of ...
RN Care Coordinator
Royal Oak, MI ยท On-site
Scope of work Under general direction, integrates cost, quality and utilization to facilitate the admission, continued stay and discharge of the patient. Reviews and evaluates appropriateness of ...
Physician Advisor (IPAS)
Detroit, MI ยท On-site
The Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and hospital leadership. The Physician ...
Physician Advisor (IPAS)
Detroit, MI ยท On-site
The Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and hospital leadership. The Physician ...
The Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and hospital leadership. The Physician ...
The Physician Advisor is a physician serving the hospital through teaching, consulting, and advising the care management and utilization review departments and hospital leadership. The Physician ...
Utilization Review information
See Rochester Hills, MI salary details
$19.69 - $23.68
2% of jobs
$23.68 - $27.66
9% of jobs
$30.38 is the 25th percentile. Wages below this are outliers.
$27.66 - $31.64
21% of jobs
The median wage is $34.86 / hr.
$31.64 - $35.62
23% of jobs
$35.62 - $39.61
13% of jobs
$42.70 is the 75th percentile. Wages above this are outliers.
$39.61 - $43.59
10% of jobs
$43.59 - $47.57
8% of jobs
$47.57 - $51.55
5% of jobs
$51.55 - $55.54
5% of jobs
$55.54 - $59.52
2% of jobs
$59.52 - $63.50
2% of jobs
$19
$38
$63
How much do utilization review jobs pay per hour?
As of Jul 19, 2026, the average hourly pay for utilization review in Rochester Hills, MI is $38.92, according to ZipRecruiter salary data. Most workers in this role earn between $30.77 and $44.71 per hour, depending on experience, location, and employer.
What jobs make $3,000 a day?
High-paying jobs that can reach $3,000 a day include specialized roles such as senior physicians, anesthesiologists, or surgeons, often requiring advanced certifications and extensive experience. Certain executive positions, like CEOs or investment bankers, may also earn this level of daily income, especially through bonuses or profit sharing. These roles typically involve high responsibility, expertise, and demanding schedules.
What jobs pay 4000 a week without a degree?
Utilization Review specialists typically do not earn $4,000 per week without a degree; most roles in this field require healthcare-related certifications or experience. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which often rely on experience, licensing, or certifications rather than formal degrees. These roles may involve commission, bonuses, or overtime to achieve such weekly earnings.
What does a typical day look like for someone working in Utilization Review?
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
What skills do you need for utilization review?
Utilization review professionals need strong analytical skills to assess medical necessity and appropriateness of care, attention to detail, and knowledge of healthcare regulations and insurance policies. Good communication skills are essential for coordinating with healthcare providers and explaining decisions. Familiarity with electronic health records (EHR) systems and relevant certifications, such as Certified Professional in Healthcare Quality (CPHQ), can also be beneficial.
What is a Utilization Review job?
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
What are the key skills and qualifications needed to thrive in the Utilization Review position, and why are they important?
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.
How do I get into a utilization review?
To become a utilization review specialist, typically a healthcare professional such as a registered nurse, licensed social worker, or physician completes relevant education and gains experience in healthcare or insurance. Certification in utilization review or case management, such as the Certified Professional in Healthcare Quality (CPHQ), can improve job prospects. Strong analytical skills and knowledge of medical coding and insurance policies are also important.
What are the most commonly searched types of Utilization Review jobs in Rochester Hills, MI? The most popular types of Utilization Review jobs in Rochester Hills, MI are:
What are popular job titles related to Utilization Review jobs in Rochester Hills, MI? For Utilization Review jobs in Rochester Hills, MI, the most frequently searched job titles are:
What job categories do people searching Utilization Review jobs in Rochester Hills, MI look for? The top searched job categories for Utilization Review jobs in Rochester Hills, MI are:
What cities near Rochester Hills, MI are hiring for Utilization Review jobs? Cities near Rochester Hills, MI with the most Utilization Review job openings:
