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Utilization Reviewer Jobs in Howell, MI (NOW HIRING)

Flex Clinical Pharmacist

Brighton, MI · On-site

$113K - $135K/yr

Documents clinical interventions, participates in quality assurance monitors, drug utilization reviews, pharmacoeconomic analysis, and monitors medication therapy outcomes as assigned. Consults with ...

RN Field Case Manager

Howell, MI · On-site

$73K - $92K/yr

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays, as assigned. * Completes and submits OASIS ...

RN Field Case Manager

Novi, MI · On-site

$73K - $92K/yr

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays, as assigned. * Completes and submits OASIS ...

RN Field Case Manager

Gaines, MI

$65K - $83K/yr

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays, as assigned. * Completes and submits OASIS ...

RN Field Case Manager

Novi, MI · On-site

$73K - $93K/yr

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays, as assigned. * Completes and submits OASIS ...

MDS RN Float - Part Time

West Bloomfield, MI · On-site

$34.50 - $41.75/hr

Facilitate the weekly utilization review of patients on skilled services for Medicare A, Medicare B and insurance patients * Review Triple Check components daily, weekly and monthly to assure ...

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays, as assigned. * Completes and submits OASIS ...

Participates in utilization review of medical records as assigned. * Gives total patient care as needed. * Takes on-call duty nights, weekends and holidays, as assigned. * Completes and submits OASIS ...

Showing results 21-40

Utilization Reviewer information

See Howell, MI salary details

$29K

$35.6K

$41.2K

How much do utilization reviewer jobs pay per year?

As of Aug 11, 2026, the average yearly pay for utilization reviewer in Howell, MI is $35,552.00, according to ZipRecruiter salary data. Most workers in this role earn between $31,800.00 and $39,300.00 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 is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient records, treatment plans, and insurance policies to ensure that care meets established guidelines and standards. Their role helps control healthcare costs while maintaining quality patient care and ensuring compliance with regulatory requirements. Utilization Reviewers often communicate with healthcare providers, insurance companies, and patients to gather information and make informed decisions.

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 are the key skills and qualifications needed to thrive as a utilization reviewer?

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.
What cities near Howell, MI are hiring for Utilization Reviewer jobs? Cities near Howell, MI with the most Utilization Reviewer job openings:
Infographic showing various Utilization Reviewer job openings in Howell, MI as of August 2026, with employment types broken down into 2% As Needed, 74% Full Time, 22% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $35,552 per year, or $17.1 per hour.

Flex Clinical Pharmacist

Trinity Health

Brighton, MI • On-site

$113K - $135K/yr

Other

Re-posted 25 days ago


Trinity Health rating

6.6

Company rating: 6.6 out of 10

Based on 354 frontline employees who took The Breakroom Quiz

571st of 887 rated healthcare providers


Job description

Employment Type:

Part time

Shift:

Rotating Shift

Description:

Position Purpose

A Clinical Pharmacist provides medication preparation, distribution services and is prospectively involved with provision of pharmaceutical care and the promotion of high-quality, cost-effective, patient-focused care for populations across the age continuum (from neonatal to geriatric patients depending on hospital populations served) in conjunction with other members of the healthcare team according to professional standards and statutory requirements. The clinical pharmacist demonstrates pharmacotherapy expertise, participates in interdisciplinary education programs, and participates in problem recognition and resolution related to medication usage, actively participates in CQI initiative development and completion and provides clinical education to pharmacy department staff, students and pharmacy residents if part of the department.

Status available: Contingent

Education:

  • Required Bachelor's degree in Pharmacy. Doctor of Pharmacy degree or equivalent clinical degree in pharmacy practice is preferred.

Experience:

  • Previous related hospital experience or hospital residency strongly preferred.

Licensure / Certification:

  • Registered pharmacist possessing or eligible for a Michigan Pharmacist and Controlled Substance license is required. Maintenance of minimum hours of State Board of Pharmacy continuing education credits every two years as required by the State of Michigan.

  • Per specific hospital policy, Current Basic Life Support (BLS) and / or Advanced Life Support (ACLS) certification as required.

REQUIRED SKILLS AND ABILITIES:

  • Interpersonal skills necessary to effectively communicate drug therapy information to all health team members, patients, and administrators / managers. Interpersonal skills necessary to interact with patients, physicians, and other healthcare providers.

  • Broad knowledge of medications compounding and dispensing. Thorough knowledge of pathophysiology, pharmacokinetics and therapeutics.

  • Analytic skills necessary to organize and prioritize multiple job duties.

  • General understanding of computers, including general operations and data retrieval.

  • Commitment to adhere to activities that promote the vision and mission of Trinity Health and the Department of Pharmacy and the principles of continuous quality improvement within the organization.

  • Demonstrated punctual professional demeanor that is willing to work variable hours on a rotating schedule.

  • Excellent customer service orientation skills necessary in order to deal effectively with various levels of hospital personnel, outside customers and community groups.

  • Communication skills necessary for clear written and oral communication.

  • Thorough knowledge of the regulatory, statutory, and professional aspects of pharmacy practice.

  • Demonstrated working knowledge of pharmacokinetics.

  • Demonstrated teaching ability.

What you will do:

Interprets and evaluates medication orders to ensure appropriateness of therapy; including, but not limited to dosage form, dose, and route of administration, schedule, starting time and duration.

Monitors patient medication regimens for possible allergies, drug-drug interactions, nutrient-drug interactions, contraindications, therapeutic duplication and potential adverse drug reactions.

Individualizes medication therapy based on patient variables including, but not limited to, renal function, age, weight, laboratory values and pharmacokinetic parameters.

Manages drug therapy and utilization across the continuum of care through communication with physicians, nurses, other healthcare providers and patients to intervene on orders that are unclear, incomplete, inappropriate, or could cause poor drug outcomes and recommends alternative therapy.

Participates in pharmaceutical care activities such as patient rounds, therapeutic drug monitoring, patient teaching and counseling, admission drug histories, antimicrobial stewardship, pain management and drug information education to healthcare professionals in response to questions or requests for in-service education.

Documents clinical interventions, participates in quality assurance monitors, drug utilization reviews, pharmacoeconomic analysis, and monitors medication therapy outcomes as assigned.

Consults with and advises physicians and other health care professionals in the development of safe, rational and cost-effective patient medication care plans.

Recommends patient specific drug therapy, evaluates therapy regimens and makes recommendations to medical staff to optimize effective drug therapy.

Educates physicians, employees and other allied disciplines about the goals and rationale of the institution's quality of care and cost containment programs related to medication usage and to pharmacotherapy and pharmaceutical care.

Directs and monitors pharmacy technicians, interns, and students in preparation, packaging, labeling and distribution of medication.

Directs, monitors and verifies the compounding of injectable medications including epidural infusions, irrigation, small and large volume parenterals, hyper alimentation and cytotoxic agents performed by pharmacy technicians as necessary based on hospital practices.

Compounds and dispenses medications and injectable medications recognizing that compounding and/or dispensing errors may result in significant patient morbidity and mortality. Competency must be demonstrated before compounding or checking compounded products. Adheres to USP 797 / USP 800 Guidelines.

Participates in hospital emergency codes responses. Provides and prepares emergency medications via emergency carts, cardiac kits and EMS/Ambulance kits as necessary based on hospital practices.

Coordinates pharmaceutical services for specified hospital units. Problem-solves, communicates with, and serves as a liaison between these units and the pharmacy department.

Actively participates in staff development programs, continuing education, lectures, conferences, and preparation of newsletters, drug class reviews, and new policies and procedures as hospital practice allows.

As hospital pharmacy department practice allows, participates in teaching programs affiliated with the Department of Pharmacy and training programs for nursing, physicians, pharmacists and other allied health professionals. Precepts Doctor of Pharmacy students on patient care activities. Meets with students regularly to review drug therapy and clinical skills. Serves as a preceptor to the pharmacy residents if trained at hospital site.

Performs duties in compliance with all federal, state and local regulatory requirements.

Maintains control and accountability for disposition of controlled substances, hazardous medications and investigational drug regulations. Properly maintains all legally required records. Maintains a working knowledge of applicable Federal, State, and Local laws and regulations, the Trinity Health Organizational Integrity Program, including the Standards of Conduct, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professionally behaviors.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.

Our Commitment to Diversity and Inclusion

Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.

EOE including disability/veteran


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About Trinity Health

Sourced by ZipRecruiter

Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Livonia, MI, US