Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Utilization Review
Cleveland, OH · On-site
Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...
Utilization Review
Cleveland, OH · On-site
Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Medical, Dental, and Vision Insurance * NPH 401(k) plan with up to 4% Company match * Employee ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. Utilization ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. Utilization ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. Utilization ...
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. Utilization ...
UTILIZATION SPECIALIST-E.D.
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. Utilization ...
UTILIZATION SPECIALIST-E.D.
Hudson, OH · On-site
... review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. Utilization ...
RN Utilization Review in Middleburg Heights, OH
Middleburg Heights, OH · On-site
$1.9K - $2.1K/wk
Now Hiring: RN Utilization Review - Middleburg Heights, OH Job ID: JOB-414060 Weekly Pay Range ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...
RN Utilization Review in Middleburg Heights, OH
Middleburg Heights, OH · On-site
$1.9K - $2.1K/wk
Now Hiring: RN Utilization Review - Middleburg Heights, OH Job ID: JOB-414060 Weekly Pay Range ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...
This role will review patient medical records to ensure accurate documentation, proper level of ... Strong verbal and written communication skills to interact with physicians and insurance payers.
This role will review patient medical records to ensure accurate documentation, proper level of ... Strong verbal and written communication skills to interact with physicians and insurance payers.
This role will review patient medical records to ensure accurate documentation, proper level of ... Strong verbal and written communication skills to interact with physicians and insurance payers.
This role will review patient medical records to ensure accurate documentation, proper level of ... Strong verbal and written communication skills to interact with physicians and insurance payers.
This role will review patient medical records to ensure accurate documentation, proper level of ... Strong verbal and written communication skills to interact with physicians and insurance payers.
This role will review patient medical records to ensure accurate documentation, proper level of ... Strong verbal and written communication skills to interact with physicians and insurance payers.
Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... Verifies and documents client eligibility and insurance coverage prior to authorization submission ...
Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... Verifies and documents client eligibility and insurance coverage prior to authorization submission ...
Insurance Utilization Review information
See Ohio salary details
$20.34 - $24.45
2% of jobs
$24.45 - $28.57
9% of jobs
$31.38 is the 25th percentile. Wages below this are outliers.
$28.57 - $32.68
21% of jobs
The median wage is $36.01 / hr.
$32.68 - $36.79
23% of jobs
$36.79 - $40.91
13% of jobs
$44.11 is the 75th percentile. Wages above this are outliers.
$40.91 - $45.02
10% of jobs
$45.02 - $49.13
8% of jobs
$49.13 - $53.25
5% of jobs
$53.25 - $57.36
5% of jobs
$57.36 - $61.48
2% of jobs
$61.48 - $65.59
2% of jobs
$20
$40
$65
How much do insurance utilization review jobs pay per hour?
As of Sep 13, 2026, the average hourly pay for insurance 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 an insurance utilization review?
An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.
What are the key skills and qualifications needed to thrive in insurance utilization review?
To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.
What are the most common challenges faced by insurance utilization review professionals?
One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.
How do I get into an insurance utilization review?
To become an insurance utilization review specialist, candidates typically need a background in healthcare, nursing, or a related field, along with knowledge of insurance policies and medical terminology. Certification such as the Certified Professional in Healthcare Quality (CPHQ) or similar credentials can enhance job prospects. Relevant skills include attention to detail, analytical thinking, and familiarity with medical records and insurance software systems.
Is insurance utilization review a stressful job?
Insurance utilization review can be stressful due to the need for accuracy, attention to detail, and meeting strict deadlines. Reviewers often handle complex cases and must balance policy guidelines with patient needs, which can contribute to job pressure. However, the level of stress varies depending on workload, work environment, and individual coping skills.
What are the most commonly searched types of Insurance Utilization Review jobs in Ohio?
The most popular types of Insurance Utilization Review jobs in Ohio are:
What are popular job titles related to Insurance Utilization Review jobs in Ohio?
For Insurance Utilization Review jobs in Ohio, the most frequently searched job titles are:
- Evening Utilization Review Nurse
- Non Exempt No Experience Utilization Management Nurse
- Remote Utilization Review Rn
- Behavioral Health Utilization Review
- Utilization Review Nurse
- Remote Utilization Management Nurse
- Night Utilization Review Nurse
- Home Based Utilization Review Nurse
- Remote Physician Advisor Utilization Review
- Remote Utilization Review Physical Therapist
What job categories do people searching Insurance Utilization Review jobs in Ohio look for?
The top searched job categories for Insurance Utilization Review jobs in Ohio are:
- Lpn Utilization Review
- Flex Schedule Utilization Review
- Nurse Practitioner Utilization Review
- Chart Utilization Review
- Per Diem Remote Occupational Therapy Utilization Review
- Case Manager Utilization Review Nurse
- Cigna Utilization Review Nurse
- Remote Bcba Utilization Review
- Manager Aetna Utilization Review
- Full Time Navihealth Utilization Review
What cities in Ohio are hiring for Insurance Utilization Review jobs?
Cities in Ohio with the most Insurance Utilization Review job openings:
Care Review Nurse
Columbus, OH • On-site
Integrated Resources
• Recruiting and Staffing Services • 51 - 200 employees51 - 200 employees
Other
Re-posted 17 hours ago
Job description
Care Review Nurse
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing 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 Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Medicaid Division
Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications: Background Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience) Potential for longer term dependent on enrollment Workers will be doing Concurrent Inpatient Review MUST have one of the following AT LEAST -Utilization Review in hospital setting Nurses who are used to doing both production and review work
All your information will be kept confidential according to EEO guidelines.
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996