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Contract Utilization Review Jobs in Ohio (NOW HIRING)

Summa Health System

RN Utilization Management

Akron, OH · On-site

$37.40 - $56.11/hr

... contracts and payment modalities such as bundled payments and shared risk arrangements ... Performs initial and concurrent clinical reviews on all the contracted and emergent non-contracted ...

Cincinnati Children's

Finance Rep II

Cincinnati, OH · On-site

$18.16 - $22.25/hr

Managing patient billing and ensure procedures are billed according to contracts, transmit or mail ... Conduct utilization review for the division from insurance companies and working in conjunction ...

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All JobsContract Utilization Review JobsContract Utilization Review Jobs in Ohio

Contract Utilization Review information

See Ohio salary details

$20

$40

$65

How much do contract utilization review jobs pay per hour?

As of Sep 3, 2026, the average hourly pay for contract utilization review in Ohio is $40.20, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.15 per hour, depending on experience, location, and employer.

What is a contract utilization review?

A Contract Utilization Review job involves analyzing and evaluating the usage of contracts to ensure compliance, cost-effectiveness, and efficiency. Professionals in this role review contract terms, monitor vendor performance, and assess utilization data to optimize contract value. They may work in industries such as healthcare, government, or procurement, ensuring that agreements are being properly executed. The goal is to identify areas for improvement, reduce waste, and enhance operational efficiency.

What does a contract utilization review do?

A typical day in Contract Utilization Review involves reviewing patient medical records, ensuring adherence to payer contracts and regulatory standards, and communicating with healthcare providers to validate medical necessity of services. Professionals in this role often collaborate with clinical staff, case managers, and insurance representatives to resolve discrepancies or authorization issues. The work is detail-oriented and deadline-driven, making organizational skills vital. This dynamic position offers significant opportunities to learn more about healthcare regulations and may serve as a stepping stone toward more advanced roles in healthcare administration or compliance.

What are the key skills and qualifications needed to thrive in contract utilization review?

To thrive in Contract Utilization Review, you need a solid understanding of medical terminology, insurance policies, and contract compliance, often supported by a healthcare-related degree or certification in utilization management. Familiarity with utilization review software, electronic medical records (EMR), and knowledge of regulatory standards such as CMS guidelines is essential. Strong analytical thinking, attention to detail, and effective communication skills are crucial for collaborating with care teams and insurers. These abilities ensure reviews are accurate, contracts are properly administered, and patient care meets organizational and payer requirements.

What are the most commonly searched types of Utilization Review jobs in Ohio?

The most popular types of Utilization Review jobs in Ohio are:

What are popular job titles related to Contract Utilization Review jobs in Ohio?

For Contract Utilization Review jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Contract Utilization Review jobs in Ohio look for?

The top searched job categories for Contract Utilization Review jobs in Ohio are:

What cities in Ohio are hiring for Contract Utilization Review jobs?

Cities in Ohio with the most Contract Utilization Review job openings:

Contract Utilization Review jobs near you
Infographic showing various Contract Utilization Review job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 17% Part Time, 5% Contract, and 1% Nights. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $83,610 per year, or $40.2 per hour.

RN Case Manager - Prior Authorization

Healthcare Support Staffing

Columbus, OH • On-site

$30/hr

Contractor

Re-posted 10 days ago

Job description

Company 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!

Job Description

Position Purpose: Review requests for contract specific prior authorization of services within a centralized unit

  • Review provider request for contract specific prior authorization through fax or telephone with application of evidence based criteria to ensure medical necessity for services
  • Act as clinical resource to unit referral specialist staff and make appropriate referrals
  • Provide provider education as directed
  •  Data entry and inquiry using both claims and clinical system software for performance of the authorization review process with documentation into the appropriate systems
Qualifications
Education/Experience: At least two years clinical nursing experience. Utilization review, prior authorization, or managed care experience preferred.
  • Active OH RN Licensure
  • Experienced with either Interqual or Milliman
Licenses/Certifications: Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
Additional Information

Advantages of this Opportunity:

Hours for this Position: Monday- Friday 8a-5p

Pay $30.00 per hour

Start date: 7/6

If you are interested, please call, Lovely 321-574-6539 and email your resume to me.


The greatest compliment to our business is a referral.

If you know of someone looking for a new opportunity, please pass along my contact information! We offer referral bonuses of up to $100.00 for each placement.





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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

Social media

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