RN Case Manager - Utilization Review Nurse Shift: 08:00 - 16:30 Assignment Details: * Contract Length: 12 weeks * Guaranteed Hours: 40 hours per week Requirements: * Active nursing license
RN Case Manager - Utilization Review Nurse Shift: 08:00 - 16:30 Assignment Details: * Contract Length: 12 weeks * Guaranteed Hours: 40 hours per week Requirements: * Active nursing license
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
Grosse Pointe, MI · 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 · 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
Farmington Hills, MI · 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 ...
New
RN Care Coordinator
Farmington Hills, MI · 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 ...
New
RN Care Coordinator
Grosse Pointe, MI · 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 · 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
Royal Oak, MI · 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 · 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 - Case Management
Detroit, MI · On-site
$2.1K/wk
Shift: 08:00 - 16:30 Assignment Details: - Contract Length: 12 weeks - Guaranteed Hours: 40 hours per week Requirements: - Active nursing license - Experience in case management or utilization review ...
RN - Case Management
Detroit, MI · On-site
$2.1K/wk
Shift: 08:00 - 16:30 Assignment Details: - Contract Length: 12 weeks - Guaranteed Hours: 40 hours per week Requirements: - Active nursing license - Experience in case management or utilization review ...
Physician Advisor (IPAS)
Detroit, MI · On-site
Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) or the American College of Physician Advisors (ACPA-C) preferred. * Ability to build ...
Physician Advisor (IPAS)
Detroit, MI · On-site
Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) or the American College of Physician Advisors (ACPA-C) preferred. * Ability to build ...
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 ...
New
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 ...
New
Physician Advisor (IPAS)
Detroit, MI · 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 · 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 ...
Drafts policy provisions and provides interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for and drafts or defines procedures/protocols in ...
Drafts policy provisions and provides interpretation of department policies, in accordance with the DMC Utilization Review Plan. Identifies the need for and drafts or defines procedures/protocols in ...
Case Manager
Detroit, MI · On-site
$55 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Quick apply
Case Manager
Detroit, MI · On-site
$55 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Case Manager
Detroit, MI · On-site
$58 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Quick apply
Case Manager
Detroit, MI · On-site
$58 - $60/hr
MANAGER IS VERY STRICT ON THE RECENT INPATIENT CASE MANAGEMENT EXPERIENCE - TELEPHONIC, UTILIZATION REVIEW, PSYCHOLOGICAL EXPERIENCE DOES NOT APPLY TO THIS REQUIREMENT.
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and accrediting agency standards and regulations relative to utilization ...
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and accrediting agency standards and regulations relative to utilization ...
Case Manager
$18.75 - $24/hr
Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and accrediting agency standards and regulations relative to utilization ...
Case Manager
$18.75 - $24/hr
Knowledge of federal, state and local regulation affecting utilization review programs and payments. Knowledge of regulatory and accrediting agency standards and regulations relative to utilization ...
Case Management
Livonia, MI · On-site
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...
Case Management
Livonia, MI · On-site
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...
Case Manager
Livonia, MI · On-site
$18.75 - $24/hr
Five years of clinical experience in nursing and recent (within 2 year) experience in utilization review/management/discharge planning or case management. • Current knowledge of third party payor ...
RN Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM - Preferred Company Description LanceSoft is rated as one of the largest staffing firms in the US by SIA.
Quick apply
RN Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM - Preferred Company Description LanceSoft is rated as one of the largest staffing firms in the US by SIA.
RN- Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM - Preferred Company Description LanceSoft is rated as one of the largest staffing firms in the US by SIA.
Quick apply
RN- Case Manager
Pontiac, MI · On-site
$2.1K - $2.2K/wk
... starting Utilization Review - Preferred Insurance Authorization experience - Preferred CCM - Preferred Company Description LanceSoft is rated as one of the largest staffing firms in the US by SIA.
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 Aug 9, 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.
Is utilization review work from home?
Utilization review jobs can often be performed remotely, especially with the increased adoption of telecommuting in healthcare and insurance industries. Many employers offer work-from-home options, provided the reviewer has the necessary certifications and access to electronic health records or claims systems. However, some positions may require on-site presence for meetings or audits.
What does a utilization review do?
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.
Is utilization review a stressful job?
Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, which can be stressful due to strict deadlines, high accuracy requirements, and the need to balance patient care with insurance policies. The job often requires strong attention to detail, communication skills, and the ability to handle complex cases under time pressure.
What is a utilization review?
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 utilization review?
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 or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, such as the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects. Relevant skills include knowledge of medical coding, insurance policies, and strong analytical abilities.
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:
Other
Re-posted 23 days ago
Detroit Medical Center rating
5.9
Based on 49 frontline employees who took The Breakroom Quiz
889th of 1,055 rated hospitals
Job description
RN Case Manager – Utilization Review Nurse
Shift: 08:00 - 16:30
Assignment Details:
- Contract Length: 12 weeks
- Guaranteed Hours: 40 hours per week
Requirements:
- Active nursing license
- Experience in case management or utilization review preferred
Roles & Responsibilities:
- Facilitate patient care along the continuum through effective resource coordination.
- Assist patients in achieving optimal health and accessing necessary resources.
- Manage the medical necessity process to ensure accurate and timely payment for services.
- Negotiate with payers on a case-by-case basis as required.
Uniforms: Nurses - Navy Blue, ER Techs/CNA/Sitters - Maroon/Burgundy, Rad Tech - Ceil Blue.
TLC Nursing Associates, Inc. is an equal-opportunity employer and fully complies with all applicable federal, state, and local laws. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability, age, genetic information, veteran status, or any other status protected under the law. Accuracy of Information: All job listings are subject to change, and while we strive to ensure that all job information, including job descriptions, pay packages, and shift details, is accurate and up-to-date, we cannot guarantee the availability or specifics of any position at the time of application. Pay packages and shift availability may vary based on facility needs and may be subject to changes before or after hire.
What Detroit Medical Center employees say
Pay
Benefits
Hours and flexibility
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About Detroit Medical Center
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Detroit, MI, US
Year founded
1886