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Utilization Reviewer Jobs in Michigan (NOW HIRING)

Acadia Healthcare

Utilization Specialist

Battle Creek, MI · On-site

Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...

UHS

UR COORDINATOR

Augusta, MI · On-site

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

UHS

UR COORDINATOR

Augusta, MI · On-site

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

UHS

UR COORDINATOR

Augusta, MI

Qualifications The Utilization Review Coordinator is responsible for reviewing patient insurance benefits and ascertaining level of care (LOC) pre-certifications. Essential Duties and ...

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All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Michigan

Utilization Reviewer information

See Michigan salary details

$27K

$33.1K

$38.4K

How much do utilization reviewer jobs pay per year?

As of Jun 29, 2026, the average yearly pay for utilization reviewer in Michigan is $33,114.00, according to ZipRecruiter salary data. Most workers in this role earn between $29,600.00 and $36,600.00 per year, depending on experience, location, and employer.

What is the difference between Utilization Reviewer vs Medical Coder?

AspectUtilization ReviewerMedical Coder
Required CredentialsTypically requires healthcare-related certifications, such as RHIT, RHIA, or CPCUsually requires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizationsHospitals, clinics, or medical billing companies
Employer & Industry UsageUsed in insurance, managed care, and healthcare administrationUsed in medical billing, coding, and health information management

While both roles work within healthcare settings, Utilization Reviewers focus on evaluating the necessity of medical services for insurance and care management, whereas Medical Coders translate medical records into standardized codes for billing and documentation. Understanding these differences helps professionals choose the right career path or job search focus.

How does a Utilization Reviewer typically collaborate with healthcare providers to ensure appropriate patient care?

Utilization Reviewers work closely with physicians, nurses, and other healthcare professionals to assess the necessity and efficiency of medical services provided to patients. They review clinical documentation, verify that treatments meet established guidelines, and may discuss care plans directly with providers to clarify information or suggest alternatives. This collaboration ensures that patients receive appropriate care while controlling costs and complying with insurance or regulatory requirements. Effective communication and a thorough understanding of medical protocols are essential for success in this role.

What does a utilization reviewer do?

A utilization reviewer evaluates medical records and treatment plans to determine the necessity and appropriateness of healthcare services. They ensure that services comply with insurance policies and industry standards, often using healthcare management software and adhering to regulatory guidelines. This role supports cost containment and quality assurance in healthcare organizations.

How to become a utilization reviewer?

To become a utilization reviewer, candidates typically need a healthcare-related degree such as nursing, health administration, or a related field. Relevant experience in healthcare or insurance, strong analytical skills, and familiarity with medical coding and documentation are important; some roles may require certification such as the Certified Professional Utilization Review (CPUR).

What jobs pay 2000 a day?

Utilization reviewers typically do not earn $2000 a day; such high daily earnings are more common in specialized roles like senior surgeons, high-level consultants, or certain executive positions. These roles often require advanced certifications, extensive experience, and work in high-paying industries such as healthcare, finance, or law. Most utilization review positions offer salaries that are significantly lower than this daily rate.

What Does a Utilization Reviewer Do?

There are different types of Utilization Reviewer jobs, including Nurse Utilization Reviewers, Insurance Utilization Reviewers, Speech Therapy, Physical Therapy, and Occupational Therapy Utilization Reviewers. Regardless of the area of focus, a Utilization Reviewer is responsible for setting best practices, reviewing healthcare program requirements, ensuring the quality of care, controlling costs, and developing and implementing initiatives for review processes. Utilization Reviewers ensure compliance of programs, regularly audit patient and client records, work with staff to implement best practices and correct problem areas, monitor industry trends, and remain up-to-date and train others on industry standards and requirements.

What job makes $10,000 a month without a degree?

A utilization reviewer typically earns between $4,000 and $8,000 per month, depending on experience and location, and usually requires relevant healthcare or insurance knowledge. Jobs that can pay $10,000 a month without a degree include high-level sales, real estate brokers, or certain skilled trades like commercial pilots or specialized technicians, often requiring certifications or extensive experience. These roles often involve self-employment, commissions, or high-demand skills that compensate well without formal college degrees.

What are the key skills and qualifications needed to thrive as a Utilization Reviewer, and why are they important?

To thrive as a Utilization Reviewer, you need a clinical background (such as RN or LCSW), in-depth knowledge of medical terminology, and an understanding of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or URAC accreditation is typically required. Strong critical thinking, attention to detail, and effective communication skills help in evaluating patient care and collaborating with providers. These competencies are crucial for ensuring appropriate, cost-effective care while maintaining compliance with healthcare standards.
More about Utilization Reviewer jobs
What are popular job titles related to Utilization Reviewer jobs in Michigan? For Utilization Reviewer jobs in Michigan, the most frequently searched job titles are:
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What cities in Michigan are hiring for Utilization Reviewer jobs? Cities in Michigan with the most Utilization Reviewer job openings:
What are popular job titles related to Utilization Reviewer jobs in MI? For Utilization Reviewer jobs in MI, the most frequently searched job titles are:
Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Michigan as of June 2026, with employment types broken down into 25% Full Time, 69% Part Time, and 6% Contract. Highlights an 51% Physical, 2% Hybrid, and 47% Remote job distribution, with an average salary of $33,114 per year, or $15.9 per hour.
Utilization Management Manager

Utilization Management Manager

Region 10 PIHP

Port Huron, MI

Full-time

Medical, PTO

Posted 22 days ago

Job description

$3,000 Sign on Bonus Available!

Overview: Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. Sign on bonus of $3,000 available. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 13 paid holidays, flexible scheduling, and a comprehensive benefit program.

Essential Functions

The UM Manager position is an administrative position with responsibility in providing direction for clinical service delivery of behavioral health services across the region respective to the Utilization Management Plan, regional clinical practice guidelines, Medicaid Provider Manual and MDHHS contract requirements.

An employee at this level will be involved in the following duties, which do not include all tasks to be performed:

  • Member of Region 10 Utilization Management Committee
  • Assists with implementing regional Utilization Management Program Plan
  • Assists with the development and generation of strategies, functions, and UM/UR monitoring/evaluation reports supporting UM Program Plan Redesign implementation
  • Directs regional Utilization Review across the CMH and SUD provider networks, including case finding, review protocol updates, and quarterly and end of year reports.
  • Serves as member on Region 10 Improving Practices Leadership Team, Region 10 Credentialing and Privilegiing Committee, and other work groups as required.
  • Assists in the development and periodic evaluation of regional clinical practice guidelines
  • Facilitates and supports provider network implementation and sustainment activities pertaining to MDHHS evidence-based practices and practice standards and guidance documents
  • Provides technical guidance in clinical issues related to regional Credentialing and Privileging policy standards
  • Provides technical guidance in clinical issues related to regional Grievance and Appeal policy standards
  • Reviews UMC quarterly reports from CMHs (Behavioral Treatment Plan services, emergency use of physical management, Adverse Benefit Determination, Customer Involvement, Wellness / Healthy Communities)
  • Provides periodic reports to the Region 10 PIHP Sentinel Events Review Committee (Critical Incidents, Sentinel Events, Risk Events Management)
  • Serves as backup to the CCO on the state-wide UM Directors Group

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