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Utilization Jobs in Michigan (NOW HIRING)

Bestica Healthcare

RN - Utilization Review

Lansing, MI · On-site

Utilization Review Rn Travel Position We at Bestica believe our success is a direct result of hard work and outstanding employee dedication. Our environment is dynamic, friendly, and collaborative.

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All JobsUtilization JobsUtilization Jobs in Michigan

Utilization information

See Michigan salary details

$18

$36

$60

How much do utilization jobs pay per hour?

As of Jun 9, 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 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 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 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 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 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
RN Medical Utilization Management Educator

RN Medical Utilization Management Educator

Spectrum Health

Grand Rapids, MI • Hybrid

Full-time

Medical, Retirement

Posted 23 days ago

Job description

Registered Nurse

Looking for Utilization Management AND Education experience.

Scope of work:
In conjunction with Medical Management leadership, coordinates the educational plan for the Behavioral Health, Care Management, and Utilization Management departments. Stakeholders include staff, physicians, department leadership, and third-party vendors. Uses specific age and culture-related physical, intellectual, psychological, and development attributes in the educational plans for staff. Reports to either a Director of Behavioral Health, Care Management, or Utilization Management with matrix reporting to other areas in Medical Management.
  • Develops/implements the educational plan for Behavioral Health, Care Management, and Utilization Management.
    Develops/implements orientation of new staff which is comprehensive and individualized with one-on-one training for three or more weeks.
    Rounding and telephonic support of staff education needs and problem solving.
    Ongoing education based on analysis of outcomes from external audits.
    Education and support for implementation and ongoing use of new electronic medical record system and supplemental ancillary computer systems.
    Collaborate with educators to Provide education and support as needed.
  • Conducts department-specific assessment for educational needs related to Compliance Monitoring and Education.
    Monthly auditing of Compliance Risk areas and identification of staff education and documentation needs to ensure compliance
    Annual education on InterQual criteria changes with annual Interrater Reliability Assessment.
    Analyze and evaluate the effectiveness of all educational activities.
  • Conducts educational workshops to medical management and related audiences as requested.
    Education of changes and payor requirements to targeted Physician groups.
  • Develops informational materials and/or other media to be distributed to internal/external customers.
    Internal/external orientation material.
    Maintains and updates repositories of educational content needed for staff orientation, day-to-day operations, and continuing education on Sharepoint sites.
    Develops annual education plan to ensure Care and Utilization management staff have access to current best practice and relevant updates.
    Monthly auditing for specific areas of focus as directed by leadership, to ensure adherence to clinical best practice.
  • Department Liaison for external audits.
    Coordinates and facilitates with other departments to ensure readiness for audits
    Analyze audit recommendations
    Reporting outcomes and development/implementation of staff education as needed.
    Assists with project and program improvement efforts
Qualifications
  • Required Bachelor's Degree
  • Preferred Master's Degree
  • Utilization Management experience highly preferred.
  • Education and/or training experience highly preferred
  • 3 years of relevant experience Must have 3 to 5 years' experience in Care Management, or Utilization Management. Required
  • Registered Nurse (RN) - State of Michigan Upon Hire required

    How Corewell Health cares for you
    • Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.
    • On-demand pay program powered by Payactiv
    • Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
    • Optional identity theft protection, home and auto insurance
    • Traditional and Roth retirement options with service contribution and match savings
    • Eligibility for benefits is determined by employment type and status

    Primary Location

    SITE - Priority Health - 1231 E Beltline Ave NE - Grand Rapids

    Department Name

    Utilization Management - PH Managed Benefits

    Employment Type

    Full time

    Shift

    Day (United States of America)

    Weekly Scheduled Hours

    40

    Hours of Work

    8 a.m. to 5 p.m.

    Days Worked

    Monday to Friday

    Weekend Frequency

    N/A

    CURRENT COREWELL HEALTH TEAM MEMBERS - Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.

    Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.

    Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.

    An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.

    You may request assistance in completing the application process by calling 616.486.7447.

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