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Contract Utilization Review Jobs in Ohio (NOW HIRING)

ScionHealth

Case Manager PRN

Dayton, OH · On-site

Utilization Management Conducts medical necessity review for appropriate utilization of services ... Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ...

Ethos Risk Services

Regional Account Manager

Columbus, OH · On-site

$59K - $85K/yr

... contracts. * CRM Excellence: Keep Salesforce updated with all sales activities, meetings, and ... Experience with nurse case management, IME, utilization review, or medical bill review services ...

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Contract Utilization Review information

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$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.

Professional Billing Finance Rep II

Cincinnati Children's

Cincinnati, OH • On-site

$18.16 - $22.25/hr

Full-time

Re-posted 13 hours ago

Cincinnati Children's Hospital Medical Center rating

7.3

Company rating: 7.3 out of 10

Based on 151 frontline employees who took The Breakroom Quiz

387th of 1,065 rated hospitals

Job description

JOB RESPONSIBILITIES
  • Billing - Compile and prepare patient charges. Prepare invoices billings, UB-04 and 1500 claim forms to be sent to 3rd party payers for payment indicating individual line items for services and total costs. Review charges. Obtain and evaluate family, third party payers and agency resources for payment of charges. Managing patient billing and ensure procedures are billed according to contracts, transmit or mail all paper and claims, and review correspondence and follow up as needed.
  • Systems Support - Maintain and update departmental system, including templates, and payer and physician information.
  • Collaboration - Act as a preceptor for new employees. Perform specialty services functions. Act as a resource within the department/division. Provide instruction for performing non-routine functions. Serve as a liaison between Physicians Billing Service, Admitting, Outpatient Surgery, Outpatient Department, Patent Financial Services and other Cincinnati Children's departments.
  • Financial Support - Obtain and evaluate family, third party payers and agency resources for payment of charges. Counsel patient on third party coverage and present financial aspects. Determine eligibility for State Medicaid, Social Security and other outside funding. Complete necessary paperwork for eligible patients, including medical and financial applications. Coordinate inpatient and outpatient admissions. Coordinate information with the inpatient and outpatient charge systems. Input charges and relative information. Manage accounts receivable data and collection information, ensure timeliness and accuracy. Research third party payers and community physician charges in order to maintain usual and customary as will as competitive charges. Check and update charge master. Conduct utilization review for the division from insurance companies and working in conjunction with Cincinnati Children's Utilization Review department. Process, post, and balance payments to accounts timely, accurately, and in the correct period.
  • Quality - Provide Quality Assurance reports for the division.

JOB QUALIFICATIONS
  • High school diploma or equivalent
  • 2+ years of work experience in a related job discipline

Primary Location
South Campus
Schedule
Full time
Shift
Day (United States of America)
Department
Professional Billing Operation
Employee Status
Regular
FTE
1
Weekly Hours
40
*Expected Starting Pay Range
*Annualized pay may vary based on FTE status
$18.16 - $22.25
About Us
At Cincinnati Children's, we come to work with one goal: to make children's health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children's.
Cincinnati Children's is:
  • Recognized by U.S. News & World Report as a top 10best Children's Hospitals in the nation for more than 15 years
  • Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding
  • Recognized as one of America's Best Large Employers (2025), America's Best Employers for New Grads (2025)
  • One of the nation's America's Most Innovative Companies as noted by Fortune
  • Consistently certified as great place to work
  • A Leading Disability Employer as noted by the National Organization on Disability
  • Magnet® designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC)

We Embrace Innovation-Together. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger future-for all of us.
Comprehensive job description provided upon request.
Cincinnati Children's is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability

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About Cincinnati Children's Hospital Medical Center

Sourced by ZipRecruiter

Cincinnati Children's Hospital Medical Center, located in Cincinnati, OH, US, is a premier pediatric hospital renowned for its exceptional clinical services, research programs, and medical education. The healthcare institution, founded in 1883, holds a sterling reputation in the industry, with a mission to improve child health and transform delivery of care through fully integrated, globally recognized research, education and innovation. As one of the oldest and most distinguished pediatric hospitals in the United States, Cincinnati Children's continues to offer a broad range of high-quality, compassionate care to children in the community and around the globe. As a testament to its dedication, it has consistently been ranked among the top three US pediatric hospitals by U.S. News & World Report.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Cincinnati, OH, US

Year founded

1883

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