Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Utilization Review Supervisor (PCN 1547)
Troy, MI · On-site
$70K - $87K/yr
Job Summary The Supervisor of Utilization Review (UR) oversees the development, implementation, and maintenance of Utilization Review (UR) clinical policies, procedures, and protocols. This position ...
Quick apply
Utilization Review Supervisor (PCN 1547)
Troy, MI · On-site
$70K - $87K/yr
Job Summary The Supervisor of Utilization Review (UR) oversees the development, implementation, and maintenance of Utilization Review (UR) clinical policies, procedures, and protocols. This position ...
Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates activities involved in the certification ...
Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates activities involved in the certification ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare ...
Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates activities involved in the certification ...
Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent, and retrospective reviews. Coordinates activities involved in the certification ...
Utilization Management Clinical Analyst HYBRID (PCN 1534)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness of behavioral health ...
Quick apply
Utilization Management Clinical Analyst HYBRID (PCN 1534)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst conducts prospective reviews of authorization requests to determine medical necessity and clinical appropriateness of behavioral health ...
As a Network Performance/Utilization Manager , your primary responsibilities may include: * Advise clients on network strategy, provider capacity, utilization trends, access challenges, and market ...
New
As a Network Performance/Utilization Manager , your primary responsibilities may include: * Advise clients on network strategy, provider capacity, utilization trends, access challenges, and market ...
New
RN Utilization Review Nurse
$33 - $37/hr
Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career ...
RN Utilization Review Nurse
$33 - $37/hr
Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the chance to advance your career ...
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 ...
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 ...
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 ...
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 ...
Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of substance use disorder authorization requests to determine ...
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Utilization Management Clinical Analyst - SUD HYBRID (PCN 1543)
Troy, MI · On-site
$56K - $70K/yr
Job Summary The Utilization Management Clinical Analyst - Substance Use Disorder (SUD) conducts prospective and concurrent reviews of substance use disorder authorization requests to determine ...
Utilization Review Analyst HYBRID (PCN 1542)
Troy, MI · On-site
$56K - $70K/yr
Job Summary Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews of service authorizations, ensuring the appropriate, effective, and efficient use of acute ...
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Utilization Review Analyst HYBRID (PCN 1542)
Troy, MI · On-site
$56K - $70K/yr
Job Summary Utilization Review Analyst conducts prospective, concurrent, and retrospective reviews of service authorizations, ensuring the appropriate, effective, and efficient use of acute ...
Senior Utilization Management Compliance and Accreditation Specialist Number of Positions: 1 Location: Detroit, MI Location Specifics: Hybrid Position Job Summary: At Delta Dental of Michigan, Ohio ...
Senior Utilization Management Compliance and Accreditation Specialist Number of Positions: 1 Location: Detroit, MI Location Specifics: Hybrid Position Job Summary: At Delta Dental of Michigan, Ohio ...
Central Utilization Mgt * Shift: Day Job * Union Code: Not Applicable
Central Utilization Mgt * Shift: Day Job * Union Code: Not Applicable
The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. Responsible for obtaining and tracking ...
The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. Responsible for obtaining and tracking ...
Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * RHIT, RHIA, or related coding certification required.
Previous utilization management or case management experience preferred. CERTIFICATIONS/LICENSURES REQUIRED: * RHIT, RHIA, or related coding certification required.
The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated ...
The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated ...
The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated ...
The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated ...
The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated ...
The Group Director, Utilization Review will perform the functions necessary to support and advance Tenet's Case Management strategy with the specific focus on Utilization Review for the designated ...
Director of Utilization Management (PCN 1527)
Troy, MI · On-site
$102K - $128K/yr
Job Summary The Director of Utilization Management (UM) is responsible for the strategic direction, continuous improvement, and oversight of the UM Department. This position will ensure individuals ...
Posted today
Quick apply
Director of Utilization Management (PCN 1527)
Troy, MI · On-site
$102K - $128K/yr
Job Summary The Director of Utilization Management (UM) is responsible for the strategic direction, continuous improvement, and oversight of the UM Department. This position will ensure individuals ...
Posted today
Utilization information
See Detroit, MI salary details
$21.18 - $25.46
2% of jobs
$25.46 - $29.75
9% of jobs
$32.68 is the 25th percentile. Wages below this are outliers.
$29.75 - $34.03
21% of jobs
The median wage is $37.50 / hr.
$34.03 - $38.31
23% of jobs
$38.31 - $42.60
13% of jobs
$45.93 is the 75th percentile. Wages above this are outliers.
$42.60 - $46.88
10% of jobs
$46.88 - $51.16
8% of jobs
$51.16 - $55.45
5% of jobs
$55.45 - $59.73
5% of jobs
$59.73 - $64.01
2% of jobs
$64.01 - $68.30
2% of jobs
$21
$41
$68
How much do utilization jobs pay per hour?
What is the difference between Utilization vs Resource Coordinator?
| Aspect | Utilization | Resource Coordinator |
|---|---|---|
| Primary Focus | Measuring and optimizing how staff time is used | Managing and assigning resources for projects |
| Required Credentials | Often no specific credentials, but industry experience helps | Typically requires organizational or project management skills |
| Work Environment | Corporate, healthcare, or consulting firms | Project teams, staffing agencies, or departments |
| Common Usage | Tracking staff utilization rates | Allocating 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?
What are some of the common challenges faced by Utilization Review Specialists when assessing medical necessity of services?
What are the key skills and qualifications needed to thrive as a Utilization Review Specialist, and why are they important?

Job description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Company: Molina Healthcare
Location: 880 Long Lake Rd Suite 600Â Troy, Michigan 48098
Shift: Daytime hours
Employment: Contract: 1-2 months (possibility of going longer depending on business needs)
Company Job Description/Day to Day Duties:
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Molina Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines
Provider appeals and Utilization reviews and assist with Denial LettersÂ
Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
Participates in interdepartmental integration and collaboration to enhance the continuity of care for Molina members including Behavioral Health and Long Term Care.Â
Minimum Education/Qualifications/Licensures:
Must be an RNÂ
Utilization Review background in either Managed Care of Provider environment (at least one year)Â
Interqual experienceÂ
Other basic computer skills necessary: Microsoft Office, Data Entry, etc.Â
Minimum 2-4 years of clinical practice. Preferably hospital nursing, utilization management, and/or case management.
Also has a background in patient, skilled nurses facilities, rehab, and home healthcare. Â
Apply now for immediate consideration. After applying, a recruiting consultant will contact you for pre-screening. Please provide your best phone number to contact.
Thanks and look forward to hearing from you!
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003