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Utilization Jobs in Michigan (NOW HIRING)

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

The Utilization Manager is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios ...

UHS

Utilization Review Manager

Grand Rapids, MI

The Utilization Manager is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

The Utilization Manager is responsible for directing and overseeing the Utilization Program for Inpatient and Outpatient services. This includes the implementation of case management scenarios ...

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Utilization information

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$18

$36

$60

How much do utilization jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for utilization in Michigan is $36.85, according to ZipRecruiter salary data. Most workers in this role earn between $29.13 and $42.31 per hour, depending on experience, location, and employer.

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

To thrive as a Utilization Review Specialist, you need a background in healthcare (often as an RN or LPN/LVN), strong analytical skills, and knowledge of insurance and medical necessity criteria. Familiarity with utilization management software, ICD-10/CPT coding, and regulatory guidelines like Medicare and Medicaid is typically required. Excellent attention to detail, critical thinking, and effective communication skills set top performers apart in this role. These abilities are crucial to accurately evaluating patient care needs, ensuring regulatory compliance, and optimizing resource use within healthcare organizations.

What are some of the common challenges faced by Utilization Review Specialists when assessing medical necessity of services?

Utilization Review Specialists often encounter the challenge of balancing patient advocacy with cost-effective care. They must stay updated on evolving insurance policies and clinical guidelines, which can be complex and change frequently. Additionally, coordinating with physicians and healthcare staff to obtain necessary documentation and clarifying treatment plans can be time-consuming. Strong communication skills and attention to detail are essential to ensure timely and accurate reviews, while also maintaining positive working relationships with clinical teams.

What are utilization specialists?

Utilization specialists are professionals who review and evaluate the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. They work closely with healthcare providers, insurance companies, and patients to ensure that care is delivered according to established guidelines and that resources are used effectively. Their goal is to help manage costs while ensuring patients receive the appropriate level of care.

What is the difference between Utilization vs Resource Coordinator?

AspectUtilizationResource Coordinator
Primary FocusMeasuring and optimizing how staff time is usedManaging and assigning resources for projects
Required CredentialsOften no specific credentials, but industry experience helpsTypically requires organizational or project management skills
Work EnvironmentCorporate, healthcare, or consulting firmsProject teams, staffing agencies, or departments
Common UsageTracking staff utilization ratesAllocating resources to projects or tasks

Utilization focuses on measuring how effectively staff time is used, often to improve productivity. Resource Coordinator involves actively managing and assigning resources to ensure project needs are met. While related, utilization is more about analysis, and resource coordination is about execution and management.

What are the most commonly searched types of Utilization jobs in Michigan? The most popular types of Utilization jobs in Michigan are:
What cities in Michigan are hiring for Utilization jobs? Cities in Michigan with the most Utilization job openings:
Utilization jobs near you
Infographic showing various Utilization job openings in Michigan as of May 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $76,654 per year, or $36.9 per hour.
Utilization Management Manager

Utilization Management Manager

Region 10 PIHP

Port Huron, MI

Full-time

Medical, PTO

Posted 25 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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