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Manager Utilization Management Jobs in Ohio (NOW HIRING)

Linen is one of the most overused resources in a hospital, and through effective management, you can support sustainability initiatives and drive cost savings for the facility to support an ...

Maintain compliancy with regulation changes affecting utilization management. PositionRequirements Bachelor's degree required. Active RN License from an accredited nursing school Minimum three to ...

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Manager Utilization Management information

See Ohio salary details

$37.1K

$86.5K

$159.2K

How much do manager utilization management jobs pay per year?

As of Jun 15, 2026, the average yearly pay for manager utilization management in Ohio is $86,524.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,600.00 and $104,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the most commonly searched types of Utilization Management jobs in Ohio? The most popular types of Utilization Management jobs in Ohio are:
What are popular job titles related to Manager Utilization Management jobs in Ohio? For Manager Utilization Management jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Ohio look for? The top searched job categories for Manager Utilization Management jobs in Ohio are:
What cities in Ohio are hiring for Manager Utilization Management jobs? Cities in Ohio with the most Manager Utilization Management job openings:
Infographic showing various Manager Utilization Management job openings in Ohio as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $86,524 per year, or $41.6 per hour.
Payer Utilization Management & Business Integration, Manager

Payer Utilization Management & Business Integration, Manager

Pwc

Cincinnati, OH • On-site

$99K - $232K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 4 days ago


PwC rating

8.4

Company rating: 8.4 out of 10

Based on 74 frontline employees who took The Breakroom Quiz

19th of 57 rated business consultants


Job description

Industry/Sector

Health Services

Specialism

Operations

Management Level

Manager

Job Description & Summary

At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance.
As an operations consulting generalist at PwC, you will possess a broad understanding of various aspects of operations consulting. You will provide comprehensive guidance and support to clients in optimising operational efficiency and effectiveness. Working in this area, you will analyse client needs, develop operational solutions, and offer recommendations tailored to specific business requirements.
Enhancing your leadership style, you motivate, develop and inspire others to deliver quality. You are responsible for coaching, leveraging team member's unique strengths, and managing performance to deliver on client expectations. With your growing knowledge of how business works, you play an important role in identifying opportunities that contribute to the success of our Firm. You are expected to lead with integrity and authenticity, articulating our purpose and values in a meaningful way. You embrace technology and innovation to enhance your delivery and encourage others to do the same.
Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:
Analyse and identify the linkages and interactions between the component parts of an entire system.
Take ownership of projects, ensuring their successful planning, budgeting, execution, and completion.
Partner with team leadership to ensure collective ownership of quality, timelines, and deliverables.
Develop skills outside your comfort zone, and encourage others to do the same.
Effectively mentor others.
Use the review of work as an opportunity to deepen the expertise of team members.
Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate.
Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements.
The Opportunity
As part of the Operations Consulting team, you will manage the delivery of technology implementations and systems integration initiatives that align with business objectives. As a Manager, you will lead teams, mentor junior staff, and secure disciplined delivery while fostering clear communication across business, IT, and vendor teams.
Responsibilities
- Oversee the implementation of technology solutions and systems integration projects
- Mentor junior staff to enhance their skills and professional growth
- Confirm disciplined project delivery aligned with business objectives
- Facilitate impactful communication between business, IT, and vendor teams
- Lead teams in identifying and resolving project-related issues
- Establish clear project goals and performance metrics
- Promote a collaborative environment to drive successful outcomes
- Evaluate project performance and implement enhancements as needed
What You Must Have
- Bachelor's Degree
- At least 5 years of experience
What Sets You Apart
- Master's Degree in Health Administration, Public Health, Business Administration/Management preferred
- Demonstrated experience leading workstreams or managing initiatives
- Managing day-to-day delivery of technology implementation
- Coordinating across business, IT, and vendor teams
- Developing KPI definitions and reporting requirements
- Translating business needs into clear BI specifications
- Excelling in stakeholder management and problem-solving
- Preparing executive-ready updates and recommendations
- Demonstrated ownership of workstream delivery and team outcomes

Travel Requirements

Up to 80%

Job Posting End Date

The salary range for this position is: $99,000 - $232,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glanceAs PwC is anequal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law.PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.Learn more about how we work: https://pwc.to/how-we-workFor only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines

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