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Manager Utilization Management Jobs in Ohio (NOW HIRING)

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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 Aug 10, 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?

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 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 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:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Ohio as of August 2026, with employment types broken down into 77% Full Time, 20% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $86,524 per year, or $41.6 per hour.

RN Utilization Rvw Spclst - Utilization Management

Kettering Health

Miamisburg, OH • On-site

Part-time

Posted 27 days ago

Kettering Health rating

7.3

Company rating: 7.3 out of 10

Based on 188 frontline employees who took The Breakroom Quiz

305th of 887 rated healthcare providers

Job description

Utilization Management | Miamisburg | Part-time | Varied Shift 


  • Registered professional nurse with education, knowledge and experience.
  • Role focuses on review of inpatient and observation admissions to ensure correct assignment of Admit status.  
  • Communicates concurrently and resolves medical necessity discrepancies with physicians and other hospital leadership as needed.
  • Responsible for completing clinical review on all assigned patients and communicates these reviews to payers.
  • Identifies potential or actual denials for admission or ongoing stay both during the patient’s hospital stay and post discharge.
  • Review and decide the validity of medical necessity payer denials.  
  • Submits payer denial appeals.
  • Participates in design of work flows and procedure to reduce incidence of denials.
  • Current unrestricted Ohio RN licensure
  • BSN required

  • 5 years clinical experience with 2 years case management
  • Case Management certification
  • Works independently
  • Familiar with MCG Care guidelines
  • Ability to adapt quickly to changing priorities and regulations
  • Experience with computers required.  Experience with Microsoft applications and EPIC software

Kettering Health is a not-for-profit system of 14 medical centers and more than 120 outpatient facilities serving southwest Ohio. Our mission is to live God’s love by promoting and restoring health. Our commitment to our patients is to help individuals be their best. With that context, safety is our top priority. We provide an integrated system of healthcare experts committed to providing exceptional care.

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