Top 12 Utilization review nurse Jobs in Hastings, Mi

Behavioral Health Utilization Management Specialist
Barry County Community Mental Health Aut —Hastings, MI
- $58,473 a year
- Full-time
- LPC
- Mid-level
- Psychology
Quick Apply
Case Manager (Multiple Openings) - Part Time 48 Hrs/Pp, Benefit Eligible - Bronson Battle Creek-2
Bronson Healthcare —Battle Creek, MI
- Part-time
- Acute care
- Nursing
- RN License
3h
Nursing Night Shift Supervisor - Full Time
Thornapple Manor —Hastings, MI
- Weekends as needed
- Nursing
- RN License
- English
- Disability insurance
- Health insurance
APP QuickCare Plus On-Call - Battle Creek
Bronson Healthcare —Battle Creek, MI
- Part-time
- Hospital
- Word processing
- Writing skills
Case Manager - Bronson Battle Creek
Bronson Healthcare —Battle Creek, MI
- Weekends as needed
- Acute care
- Nursing
- RN License
Quick Apply
APP Inpatient Infectious Disease NP or PA-C - Battle Creek, Michigan
Bronson Healthcare —Battle Creek, MI
- Email
- Acute care
- Hospital
- Word processing
Appeals Professional III (Licensed Clinician)
Tanaq Support Services LLC —United States
- Full-time
- Remote
- Nursing
- RN License
- Writing skills

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Case Manager (Multiple Openings) - Part Time 48 Hrs/Pp, Benefit Eligible - Bronson Battle Creek-2
Bronson Healthcare —Battle Creek, MI
Answers calls for Employee Incident Hot Line after hours, on weekends, and holidays. Documents all calls on the Employee injury & Illness Incident Report.
3h

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Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…
Case Manager (RN) - Full-Time
OhioHealth Rehabilitation Hospital —Columbus, OH
Current Licensure per state guidelines in clinical or related discipline OR a Bachelor's or Master's in a health or human services discipline.
$70,000 - $84,000 a year
Quick Apply
5d

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utilization review nurse jobs near hastings, mi

Behavioral Health Utilization Management Specialist

Barry County Community Mental Health Aut -
Hastings, MI

Quick Apply

Job Details

Full-time
$58,473 a year

Qualifications

Master's degree in social work
Collaborate with healthcare professionals
Clinical compliance checks
Electronic health records (EHR) management
Managed care organization experience
LMSW
LPC
Master's degree in psychology
Mid-level
Pre-authorization review for utilization management
Utilization management
Counseling
Quality improvement
Psychology
Resource utilization in healthcare
Concurrent review in utilization management
Social Work
Regulatory compliance analysis
Documentation review
Communication skills
Master's degree in counseling
Documentation reviews

Full Job Description

Location: Primarily Remote (Michigan-based)
Schedule: Full-Time | Option for Four-Day Work Week

Position Overview:
We are seeking a detail-oriented and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ensure medical necessity, regulatory compliance, and appropriate level of care determinations. The ideal candidate brings strong clinical judgment, experience with managed care or utilization management processes, familiarity with Community Mental Health/CMHSP operations, and the ability to work independently in a remote environment.

Key Responsibilities:

Conduct utilization reviews for behavioral health services, including initial, concurrent, and retrospective reviews
Assess clinical documentation to determine medical necessity and appropriate level of care
Ensure compliance with state, federal, and payer-specific regulations and guidelines
Collaborate with providers, care teams, and internal stakeholders to support quality service delivery
Maintain accurate and timely documentation of all UM activities
Participate in audits, quality improvement initiatives, and process enhancements
Stay current on best practices, regulatory updates, and industry standards in behavioral health and managed care

Qualifications:

Master’s degree in Social Work, Professional Counseling, Psychology, or a related behavioral health field
Current, active licensure in the State of Michigan (e.g., LMSW/LLMSW, LPC/LLPC, LLP/TLLP)
Prior experience in utilization management, managed care, or similar review functions required
Strong attention to detail and critical thinking skills
Excellent written and verbal communication abilities
Ability to work independently while managing multiple priorities

Preferred Qualifications:

Experience with behavioral health payer guidelines and authorization processes
Familiarity with electronic health records and UM software systems

What We Offer:

Four-day work week promoting work-life balance
Primarily remote work environment with flexible scheduling
Collaborative and mission-driven team culture
Opportunities for professional growth and development

How to Apply:
Interested candidates should submit a resume and cover letter outlining their relevant experience and licensure status.

We are an equal opportunity employer committed to diversity, equity, and inclusion in the workplace.

Quick Apply

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utilization review nurse jobs in hastings, mi

Behavioral Health Utilization Management Specialist

Case Manager (Multiple Openings) - Part Time 48 Hrs/Pp, Benefit Eligible - Bronson Battle Creek-2

Nursing Night Shift Supervisor - Full Time

APP QuickCare Plus On-Call - Battle Creek

Case Manager - Bronson Battle Creek

APP Inpatient Infectious Disease NP or PA-C - Battle Creek, Michigan

Appeals Professional III (Licensed Clinician)

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