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Utilization Reviewer Jobs in Howell, MI (NOW HIRING)

Hope At Home Health Care

RN Field Case Manager

Fenton, MI · On-site

$100K/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 ...

Hope At Home Health Care

RN Field Case Manager

Fenton, MI · On-site

$100K/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 ...

Hope At Home Health Care

RN Field Case Manager

Fenton, MI · On-site

$100K/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 ...

Hope At Home Health Care

RN Field Case Manager

Fenton, MI · On-site

$100K/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 ...

Hope At Home Health Care

RN Field Case Manager

Holly, MI · On-site

$100K/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 ...

Hope At Home Health Care

RN Field Case Manager

Holly, MI · On-site

$100K/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 ...

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Showing results 41-60

All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Howell, MI

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.
More about Utilization Reviewer jobs
What cities near Howell, MI are hiring for Utilization Reviewer jobs? Cities near Howell, MI with the most Utilization Reviewer job openings:
Utilization Reviewer jobs near you
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.

RN Field Case Manager

Hope At Home Health Care

Pinckney, MI • On-site

$100K/yr

Full-time

Re-posted 10 days ago

Job description

We are looking for a compassionate RN to join our growing team! The right candidate has a can-do attitude, a friendly demeanor, excellent interpersonal skills, and the ability to provide medical support to our clients in their homes.
 

WHY BE A RN FIELD CASE MANAGER WITH HOPE AT HOME...

  • Earn upwards of $100k per year (based on full-time hours & must be able to drive to referrals within our service area)!!!
  • Flexible schedules (work days, nights, evenings, weekends - we'll work around your needs)!!!

So become a part of the Hope At Home Family and apply TODAY (serious applicants only)!

We currently have a position available for an experienced Home Health Care Registered Nurse! A RN with Mediport, PICC Line, Wound Care, and Infusion experience is greatly preferred.

The corporate office is located in Southfield, MI and the individual will provide RN support throughout our service area within the Tri-County area (Oakland, Macomb & Wayne, Livingston, Washtenaw 

A Registered Nurse administers skilled nursing care to patients on an intermittent basis in their place of residence. This is performed in accordance with physician orders and plan of care under the direction and supervision of the Clinical Manager/Nursing Supervisor.

QUALIFICATIONS:

  • Graduate of an approved school of professional nursing and currently licensed in the state of Michigan
  • One year nursing experience
  • Kinnser - EMR experience preferred
  • Home Healthcare experience preferred
  • Experience in Wound Vac, PICC line and Mediport care, preferred
  • Pediatric experience, desired

RESPONSIBILITIES:

  • Provides services in accordance with the plan of care.
  • Makes the initial evaluation visit and regularly reevaluates the patient's nursing needs.
  • Initiates the plan of care and necessary revisions.
  • Provides those services requiring substantial specialized nursing skills.
  • Initiates appropriate preventive and rehabilitative nursing procedures.
  • Prepares clinical and progress notes for each patient visit and summaries of care conferences on his/her patients in a timely manner as per Agency policy.
  • Coordinates services.
  • Inform personnel of changes in the condition and needs of the patient.
  • Counsels the patient and family/significant others in meeting nursing and related needs.
  • Participates in and presents in-service programs.
  • Understands and adheres to established Agency policies and procedures.
  • Processes orders and notifies physician of patient needs and changes in condition. Completes certification/recertification orders and discharge summaries.
  • Determines the amount and type of nursing needed by each individual patient.
  • Refers to Physical Therapist, Speech Language Pathologist, Occupational Therapist and Medical Social Worker those patients requiring their specialized skills.
  • Supervises and teaches other nursing personnel.
  • Conducts patient care conferences on patients assigned to his/her care.
  • Participates in peer review and performance improvement as assigned.
  • 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 assessments, reassessments, transfers, resumptions of care, discharges and significant change in condition in accordance with Agency defined time frames.
  • Appropriately utilizes ICD-10 codes.

WORKING ENVIRONMENT:
Works indoors in Agency office and patient homes and travels to/from patient homes.

 
HOPE At Home Health Care is a full service home care agency dedicated to helping people excel in the comfort of their home. We offer Medicare certified skilled services. Whether you are recovering from injury or illness, or simply want to reinvigorate your mobility and health, HOPE At Home Health Care has a solution for you.
 
We are an equal opportunity employer and prohibit discrimination/harassment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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