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Remote Utilization Management Jobs in Cleveland, OH

Imh

RN Care Manager PRN

Cleveland, OH · Remote

$41.20 - $62.17/hr

Case Management Certification * Demonstrated experience in case management, utilization review ... If applying for a remote or hybrid role, this includes remote work expectations related to ...

Pyrovio

Oracle Unifier Consultant (Remote)

Akron, OH · Remote

$65 - $82/hr

Manage upgrades, patches, and system optimization. Project Controls & Process Management Implement ... system utilization. Analyze data and generate reports to assist in decision-making and project ...

All JobsUtilization Management JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Cleveland, OH

Remote Utilization Management information

See Cleveland, OH salary details

$20

$41

$66

How much do remote utilization management jobs pay per hour?

As of Aug 24, 2026, the average hourly pay for remote utilization management 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 remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What are the key skills and qualifications needed to thrive in remote utilization management?

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

How does a remote utilization management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

What are the most commonly searched types of Utilization Management jobs in Cleveland, OH?

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

What are popular job titles related to Remote Utilization Management jobs in Cleveland, OH?

For Remote Utilization Management jobs in Cleveland, OH, the most frequently searched job titles are:

What job categories do people searching Remote Utilization Management jobs in Cleveland, OH look for?

The top searched job categories for Remote Utilization Management jobs in Cleveland, OH are:

What cities near Cleveland, OH are hiring for Remote Utilization Management jobs?

Cities near Cleveland, OH with the most Remote Utilization Management job openings:

Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Cleveland, OH as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 85% Physical, 2% Hybrid, and 13% Remote job distribution, with an average salary of $85,293 per year, or $41 per hour.

Optometrist - Remote

Cleveland, OH • On-site, Remote

Health Partners of Western Ohio
Health Care and Social Assistance • 51 - 200 employees
Learn more about Health Partners of Western Ohioexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago

Job description

Optometrist (Remote) - School Based Outreach
This is a full-time position following the assigned school districts school year and paid all year round.
(Monday through Friday 7:30am - 4:00pm)
The school year includes all working days for teachers, including remote work days, and is subject to potential modifications throughout the school year.
POSITION PURPOSE
The Optometrist is primarily responsible for examining the eyes and other parts of the visual system. In addition, the Optometrist will also diagnose and treat visual problems and manage diseases, injuries, and other disorders of the eyes. The Optometrist will also prescribe eyeglasses or contact lenses as needed. The Optometrist will promote eye health and counsel patients on how general health can affect eyesight. Position can be located remote or hybrid.
QUALIFICATIONS
EDUCATION/CERTIFICATION: Must complete a Doctor of Optometry (O.D.) degree program from an accredited optometry school and complete all sections of the National Board of Examiners in Optometry exam. Current license to practice as a Doctor of Optometry (O.D.).
REQUIRED KNOWLEDGE: Successful completion of in-house training.
EXPERIENCE REQUIRED: Minimum of 5 years as a practicing Doctor of Optometry (O.D).
BENEFITS:
  • Paid Time Off (PTO)
  • Insurance (Medical, Dental, and Vision)
  • Paid Holidays
  • 403b Retirement with up to 8% match (starts at 3% and increases with time of service at HPWO)
  • Eligible to Apply for National Health Service Corps Loan Repayment
  • Continuing Education Money ($3,000) that can be used for license, DEA, memberships, CE classes and travel expenses.
  • Annual Raises
  • Training Opportunities

ESSENTIAL FUNCTIONS AND BASIC DUTIES:
  • Assist with establishing vision policies, quality improvement procedures, and evaluating current practices, policies, and procedures.
  • Staying abreast of changing healthcare landscape and opportunities for utilization of technologies to support the enhanced provision of vision services for patients.
  • Maintain supervision and communication with optical and support staff to optimize quality clinical care and services.
  • Provides leadership in developing the vision care plan and review of the program requirements; and recommends changes when necessary to carry out the vision plan as required.
  • Assist the Clinical Director in designing, implementing, and evaluating educational programs for the Health Partners of Western Ohio patients and vision staff.
  • Assume quality care for all patients.
  • Complete patient history and conduct eye examinations using optometric equipment and general diagnostic interpretation.
  • Diagnose sight problems, such as nearsightedness or farsightedness, and eye diseases, such as glaucoma.
  • Prescribe eyeglasses, contact lenses, and other visual aids, and if state law permits, medications.
  • Provide treatments such as vision therapy or low-vision rehabilitation.
  • Evaluate patients for the presence of other diseases and conditions, such as diabetes or hypertension, and refer patients to other healthcare providers as needed.
  • Promote eye and general health by counseling patients.
  • Analyze test results and develop a treatment plan.
  • Adhere to the highest standards of vision practice, ethics, and professionalism.
  • Recommend changes in all vision areas, and/or general areas to improve the patient flow, medical records, billing practices, and appointment practices.
  • Document all patient care provided according to policy.
  • Formulate and direct a plan of care for the patient.
  • Refer to physicians or specialists, as needed.
  • Respond to vision emergencies.
  • Other duties as required by the funding agencies to carry out contractual agreements and/or as established by the Health Partners of Western Ohio, Management and Board of Directors.
  • Must become familiar with the Federal and State rules, regulations, and practices in a Community Health Center.
  • Become familiar with Federal and State Health care program requirements and assist in carrying out these programs.
  • Assist in developing the vision care plan and review of the program requirements; and recommend changes when necessary to carry out the vision plan as required.
  • Adhere to the Health Partners of Western Ohio Integrated Health Care Philosophy.
  • Participate in Performance Improvement/Risk Management Program.
  • Utilize supplies cost-effectively while ensuring that the vision department stays within budget.
  • Participate in continuing education and professional growth.
  • Maintain knowledge of, and complies with, personnel and Vision policies and procedures.
  • Adhere to the standards and policies of the Organizational Privacy/ Security and Compliance Programs, including the duty to comply with applicable laws and regulations (HIPAA, OSHA, OIG guidelines, and other State and Federal laws).
  • Promote eye and general health by counseling patients.
  • Analyze test results and develop a treatment plan.
  • Adhere to the highest standards of vision practice, ethics, and professionalism.
  • Recommend changes in all vision areas, and/or general areas to improve the patient flow, medical records, billing practices, and appointment practices.
  • Document all patient care provided according to policy.
  • Formulate and direct a plan of care for the patient.
  • Refer to physicians or specialists, as needed.
  • Respond to vision emergencies.
  • Other duties as required by the funding agencies to carry out contractual agreements and/or as established by the Health Partners of Western Ohio, Management and Board of Directors.
  • Must become familiar with the Federal and State rules, regulations, and practices in a Community Health Center.
  • Become familiar with Federal and State Health care program requirements and assist in carrying out these programs.
  • Assist in developing the vision care plan and review of the program requirements; and recommend changes when necessary to carry out the vision plan as required.
  • Adhere to the Health Partners of Western Ohio Integrated Health Care Philosophy.
  • Participate in Performance Improvement/Risk Management Program.
  • Provide services in office and throughout community in an outreach manner.
  • May be responsible for driving HPWO vehicle to provide services.
  • Employee is to follow all policies and procedures regarding company vehicle.
  • The position is responsible for other duties as assigned.

WORK ENVIRONMENT
Work is primarily sedentary, demanding sitting, walking, lifting, and bending. Those physical movements and the degree of mobility, manual dexterity, and hand-eye coordination commonly associated with duties in an office setting will be performed repetitively. This also includes bending, twisting, reaching, lifting, pulling, pushing, and walking. The ability to distinguish letters and symbols and utilize telephones, computer terminals, fax machines, and copiers is required. The work environment characteristics described here represent those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. Working under stressful conditions, as well as irregular hours, may be required.

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