ZipRecruiter

Log In

1

Utilization Reviewer Jobs in Warren, MI (NOW HIRING)

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

Spectrum Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

Corewell Health

Utilization Mgmt Spec

Southfield, MI · On-site

Provides clerical support for Utilization Management; sorting faxes and mail, obtaining authorization numbers, completing follow-up on outstanding cases, and delivery of letters associated with ...

OpTech LLC

RN Utilization Management

Detroit, MI · On-site

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ... Utilization Management experience/role * Technical - MS Office, Type 35+ WPM, Dual monitors ...

OpTech

RN Utilization Management

Detroit, MI · On-site

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ... Utilization Management experience/role * Technical - MS Office, Type 35+ WPM, Dual monitors ...

previous pagenext page

Showing results 21-40

All JobsUtilization Reviewer JobsUtilization Reviewer Jobs in Warren, MI

Utilization Reviewer information

See Warren, MI salary details

$29K

$35.6K

$41.2K

How much do utilization reviewer jobs pay per year?

As of Sep 7, 2026, the average yearly pay for utilization reviewer in Warren, MI is $35,596.00, according to ZipRecruiter salary data. Most workers in this role earn between $31,900.00 and $39,400.00 per year, depending on experience, location, and employer.

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.

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 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 do I become a utilization review nurse?

To become a utilization review nurse, you typically need to hold a registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional Utilization Review (CPUR) or Certified Case Manager (CCM) can enhance job prospects, and strong knowledge of healthcare policies and documentation is essential.

Is utilization review a good job?

Utilization reviewers evaluate medical necessity and appropriateness of healthcare services, often working in healthcare or insurance settings. The role requires attention to detail, knowledge of healthcare policies, and sometimes certification, with typical schedules being standard business hours. It can offer stable employment and opportunities for advancement in healthcare administration.
More about Utilization Reviewer jobs

What are popular job titles related to Utilization Reviewer jobs in Warren, MI?

For Utilization Reviewer jobs in Warren, MI, the most frequently searched job titles are:

What job categories do people searching Utilization Reviewer jobs in Warren, MI look for?

The top searched job categories for Utilization Reviewer jobs in Warren, MI are:

What cities near Warren, MI are hiring for Utilization Reviewer jobs?

Cities near Warren, MI with the most Utilization Reviewer job openings:

Utilization Reviewer jobs near you
Infographic showing various Utilization Reviewer job openings in Warren, MI as of August 2026, with employment types broken down into 2% As Needed, 83% Full Time, 13% Part Time, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $35,596 per year, or $17.1 per hour.

Coordinator-Utilization Review(Clinical Coding)/Full Time/Remote

Henry Ford Health System

Troy, MI • On-site, Remote

Full-time

Re-posted 14 days ago

Henry Ford Health rating

7.0

Company rating: 7.0 out of 10

Based on 575 frontline employees who took The Breakroom Quiz

420th of 898 rated healthcare providers

Job description

In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient instead of outpatient. You will also review the CPTs that were boarded for meeting inpatient on the CMS inpatient list and the InterQual inpatient list based on payer criteria used.
Hours are Monday - Friday from 830am until 5pm with no weekends
EDUCATION AND EXPERIENCE:
  • RHIT, RHIA, or related coding certification required.
  • Minimum 3-5 years of clinical experience preferred.
  • Previous utilization management or case management experience preferred.

CERTIFICATIONS/LICENSURES REQUIRED:
  • RHIT, RHIA, or related coding certification required.

What Henry Ford Health employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Henry Ford Health logo

About Henry Ford Health

Sourced by ZipRecruiter

Henry Ford Health provides a full continuum of services from Primary and Preventative care, to Complex and Cpecialty care, Health Insurance, a full suite of home health offerings, Virtual care, Pharmacy, Eye care and other Healthcare retail. It is one of the Nation’s leading Academic Medical Centers, recognized for Clinical excellence in Cancer care, Cardiology and Cardiovascular Surgery, Neurology and Neurosurgery, Orthopedics and Sports medicine, and Multi organ transplants. Consistently ranked among the top five NIH funded institutions in Michigan, Henry Ford Health engages in more than 2,000 research projects annually. Equally committed to educating the next generation of Health Professionals, Henry Ford Health trains more than 4,000 Medical students, Residents and fellows every year across 50+ accredited programs. With more than 33,000 valued team members, Henry Ford Health is also among Michigan’s largest and most Diverse employers, including nearly 6,000 physicians and researchers from the Henry Ford Medical Group, Henry Ford Physician Network and Jackson Health Network.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Detroit, MI, US

Year founded

1915

View All Henry Ford Health Jobs

Apply