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Insurance Utilization Review Jobs in Cleveland, OH

Southwest General

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 ...

Southwest General

UTILIZATION SPECIALIST

Beachwood, 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 ...

Southwest General

UTILIZATION SPECIALIST

Brunswick, 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 ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH

... 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 ...

Southwest General

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 ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH

... 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 ...

Southwest General

UTILIZATION SPECIALIST

Berea, 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 ...

Southwest General

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 ...

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All JobsInsurance Utilization Review JobsInsurance Utilization Review Jobs in Cleveland, OH

Insurance Utilization Review information

See Cleveland, OH salary details

$20

$41

$66

How much do insurance utilization review jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for insurance utilization review in Cleveland, OH is $41.01, according to ZipRecruiter salary data. Most workers in this role earn between $32.40 and $47.12 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 Cleveland, OH?

The most popular types of Insurance Utilization Review jobs in Cleveland, OH are:

What are popular job titles related to Insurance Utilization Review jobs in Cleveland, OH?

For Insurance Utilization Review jobs in Cleveland, OH, the most frequently searched job titles are:

What job categories do people searching Insurance Utilization Review jobs in Cleveland, OH look for?

The top searched job categories for Insurance Utilization Review jobs in Cleveland, OH are:

What cities near Cleveland, OH are hiring for Insurance Utilization Review jobs?

Cities near Cleveland, OH with the most Insurance Utilization Review job openings:

Insurance Utilization Review jobs near you
Infographic showing various Insurance Utilization Review job openings in Cleveland, OH as of August 2026, with employment types broken down into 1% As Needed, 73% Full Time, 20% Part Time, and 6% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $85,293 per year, or $41 per hour.

Utilization Review

Prime Time Healthcare

Cleveland, OH • On-site

Other

Medical, Dental, Vision, Retirement

Posted 20 days ago

Job description

Now Hiring: RN Utilization Review - Middleburg Heights, OH

Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in Middleburg Heights, OH and make a real impact in patient care!

In this role, you'll be at the forefront of healthcare, delivering top-notch care with precision and compassion. As an integral part of our team, you'll collaborate closely with fellow healthcare professionals, ensuring every patient receives the highest level of care possible.

If you're ready to elevate your career and make a difference in the lives of others, apply today!

At Prime Time Healthcare, we offer competitive compensation along with a large range of benefits including:

  • Competitive compensation and weekly direct deposit
  • Compliance Support Specialist & Onboarding Assistance
  • Dedicated recruiter for personalized support
  • Paid, safe, pet-friendly lodging (if applicable)
  • Round-the-clock customer support 24/7
  • Unlimited referral bonus up to $750
  • Medical, Vision & Dental insurance
  • 401(k) Matching Program
  • Flexible Schedules
  • Travel Discounts

Prime Time Healthcare, LLC is an Equal Opportunity Employer (EOE).

*Estimated pay and benefits packages are on a per facility basis and may change with market conditions. Exact pay and benefits package will be negotiated with Prime Time Healthcare and may vary with several factors including but not limited to, guaranteed hours, travel distance, demand, eligibility, etc.

PrimeTime Healthcare logo

About PrimeTime Healthcare

Sourced by ZipRecruiter

PrimeTime Healthcare, based in Omaha, NE, US, is a leading provider of staffing solutions in the healthcare industry. According to information accessed from their official website, primetimehealthcare.com, the company specializes in placing high-quality healthcare professionals into temporary and travel positions across a vast network of healthcare facilities nationwide. Founded in 2012, PrimeTime Healthcare quickly established a reputation for customer-focused and result-oriented services, earning it a place on Staffing Industry Analyst’s fastest-growing staffing companies list.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Omaha, NE, US

Year founded

2012

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