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Utilization Case Manager Jobs in Akron, OH (NOW HIRING)

PATH INTEGRATED HEALTH

Case Manager

Cleveland, OH

$19.25 - $25/hr

TITLE: Case Manager, Behavioral Health RESPONSIBLE TO: Regional Leadership WORK AREA: Outpatient ... Identify and address gaps in service, as well as monitor under and over-utilization of authorized ...

Phoenix Group Home, LLC

Case Manager

Cleveland, OH · On-site

$18.25 - $23.50/hr

TITLE: Case Manager, Behavioral Health RESPONSIBLE TO: Regional Leadership WORK AREA: Outpatient ... Identify and address gaps in service, as well as monitor under and over-utilization of authorized ...

Cynet Health

RN - Case Manager

Cleveland, OH

RN Utilization Specialist Job Title: RN Utilization Specialist Profession: RN Utilization ... Case Management or Utilization Management experience required - Experience with conducting 30 or ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

... care case management to ensure the appropriateness of services, utilization of hospital resources, and quality of care rendered. Accurate and efficient application of screening criteria will be ...

GQR

RN - Case Manager

Middleburg Heights, OH

$2.10K - $2.20K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Middleburg Heights, Ohio Start Date: June 1, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2104 ...

Cleveland Clinic

RN Case Manager

Cleveland, OH

$106.13K/yr

Two years of recent experience in utilization review, quality or care management * Knowledge of ... Case Manager, RN Case Manager, Registered Nurse Case Manager, Critical Care RN, Critical Care ...

Signature Health Inc

Case Manager

Beachwood, OH

$19.25 - $24.75/hr

Participates in all quality assurance and utilization review activities. * Comply with all agency ... previous case management or relevant experience preferred. * CDCA preferred. * Strong computer ...

Signature Health Inc

Case Manager

Beachwood, OH · On-site

$19.25 - $24.75/hr

Participates in all quality assurance and utilization review activities. * Comply with all agency ... previous case management or relevant experience preferred. * CDCA preferred. * Strong computer ...

ARMS Staffing

RN - Case Management

Cleveland, OH

Conduct case management and utilization management reviews. * Perform 30+ reviews daily using screening criteria. * Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent ...

ARMS Staffing

RN - Case Management

Cleveland, OH · On-site

Conduct case management and utilization management reviews. * Perform 30+ reviews daily using screening criteria. * Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent ...

ARMS Staffing

RN - Case Management

Cleveland, OH · On-site

Conduct case management and utilization management reviews. * Perform 30+ reviews daily using screening criteria. * Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent ...

Talent4Health

RN - Case Management

Cleveland, OH

$2.05K/wk

Conduct case management and utilization management reviews. * Perform 30+ reviews daily using screening criteria. * Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent ...

Talent4Health

RN - Case Management

Cleveland, OH

$2.05K/wk

Conduct case management and utilization management reviews. * Perform 30+ reviews daily using screening criteria. * Utilize screening criteria such as Cerner, InterQual, and MCG. * Provide excellent ...

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Utilization Case Manager information

See Akron, OH salary details

$15

$34

$57

How much do utilization case manager jobs pay per hour?

As of May 28, 2026, the average hourly pay for utilization case manager in Akron, OH is $34.91, according to ZipRecruiter salary data. Most workers in this role earn between $28.27 and $36.78 per hour, depending on experience, location, and employer.

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

To thrive as a Utilization Case Manager, you need a background in nursing or social work, strong analytical skills, and a solid understanding of healthcare regulations and insurance processes, often supported by RN licensure or certification in case management (e.g., CCM). Familiarity with utilization management software, electronic health records (EHRs), and payer authorization systems is essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration among patients, providers, and payers. These skills ensure appropriate care delivery, cost management, and compliance with healthcare standards.

How does a Utilization Case Manager typically collaborate with healthcare providers and insurance companies?

Utilization Case Managers play a key role in coordinating care between healthcare providers and insurance companies. They review patient cases to ensure that the recommended treatments are medically necessary and align with insurance policies. This often involves regular communication with doctors, nurses, and insurance representatives to gather information, clarify treatment plans, and advocate for appropriate patient care. Strong collaboration skills are essential, as Utilization Case Managers must balance the needs of patients with organizational guidelines while maintaining positive professional relationships.

What is a Utilization Case Manager?

A Utilization Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical services provided to patients. They review patient cases, coordinate with healthcare providers, and ensure that treatments are in line with established guidelines and insurance requirements. Their goal is to optimize patient outcomes while managing costs and ensuring compliance with regulations. Utilization Case Managers often work in hospitals, insurance companies, or managed care organizations.

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

AspectUtilization Case ManagerUtilization Review Nurse
CredentialsRN license, case management certificationRN license, certification in utilization review
Work EnvironmentCase management teams, hospitals, insurance companiesUtilization review departments, hospitals, insurance providers
Primary FocusCoordinating patient care, discharge planning, resource allocationAssessing medical necessity, reviewing patient records for appropriateness
Common UsageBroader case management roles, patient advocacySpecific review of medical necessity and insurance claims

While both roles require RN licensure and focus on patient care, the Utilization Case Manager primarily coordinates overall patient services and discharge planning, whereas the Utilization Review Nurse concentrates on evaluating the medical necessity of treatments for insurance purposes. Understanding these distinctions helps in choosing the right career path or job search focus.

What are popular job titles related to Utilization Case Manager jobs in Akron, OH? For Utilization Case Manager jobs in Akron, OH, the most frequently searched job titles are:
What job categories do people searching Utilization Case Manager jobs in Akron, OH look for? The top searched job categories for Utilization Case Manager jobs in Akron, OH are:
What cities near Akron, OH are hiring for Utilization Case Manager jobs? Cities near Akron, OH with the most Utilization Case Manager job openings:
Utilization Case Manager jobs near you
PRN RN Case Manager (PRN - As Needed)

PRN RN Case Manager (PRN - As Needed)

Wooster Community Hospital

Wooster, OH

Other

Posted 12 days ago

Wooster Community Hospital rating

6.3

Company rating: 6.3 out of 10

Based on 16 frontline employees who took The Breakroom Quiz

738th of 989 rated hospitals

Job description

Wooster Community Hospital Job Description
PRN RN Case Manager/Inpatient Services
MAIN FUNCTION:
The PRN - RN Case Manager plays a critical role in coordinating and managing patient care through the continuum, on an as-needed basis, within the acute medical units at Wooster Community Hospital. This position supports the physician and interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care. Working in a flexible, PRN capacity, the RN CM will respond to fluctuating patient volumes and provide expert clinical judgment to support continuity of care.
RESPONSIBLE TO: Manager, Care Management
MUST HAVE REQUIREMENTS:
  • Active unrestricted Ohio RN license.
  • Bachelor's Degree
  • Acute care nursing and/or case management experience
  • No written disciplinary action with the last 12 months.
COMPLEXITY OF WORK:
Requires critical thinking skills, decisive judgment and ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
PREFERRED ATTRIBUTES:
  • Prior case management experience strongly preferred
  • 5-years of experience in an acute care setting
  • Critical care experience
  • Knowledge of discharge processes and resource utilization.
  • Case management experience in an acute care setting
  • Certification in Case Management through ACMA
POSITION EXPECTATIONS:
  • Performs all aspects of Case Management, including care coordination, discharge planning and resource management.
  • Determines appropriate level of care based on the intensity of effort required to diagnose, treat, preserve or maintain the patient's physical or emotional state.
  • Verifies that all inappropriate admissions, unnecessary continued days, and procedures not meeting approved indications are reviewed and discussed with the attending physician.
  • Identifies delays in care or services and reports the findings to the appropriate department manager or attending physician.
  • Interviews patients, patient representatives, and/or patients' family/friends when appropriate; meets their psychosocial needs within the scope of authority and established procedures and protocols.
  • Collaborates with patient/patient representative, patient caregiver, social worker, and multidisciplinary team to determine discharge plan for patients.
  • Participates in multidisciplinary rounds working with the team to organize, secure, integrate and modify the resources necessary to ensure the patient is getting the right treatment in the right place at the right time.
  • Participates in daily huddles to review LOS concerns, contributing knowledgeable to the discussion and enacting follow up recommendations
  • Communicates with medical staff, hospital personnel, and post-acute providers to provide continuum of care to all patients.
  • Initiates the discharge plan for patients of all ages and coordinates and arranges services needed by the patient post-discharge in collaboration with the discharge planning assistant.
  • Regularly evaluates the need for continued hospitalization and for necessary changes in the discharge plan with subsequent documentation of such.
  • Makes recommendations for changes in the department's policies, procedures and protocols.
  • Anticipates and reports potential problems to appropriate personnel.
  • Monitors appropriateness of admissions and continued stay to specialty areas (Telemetry, ICU).
  • Ensures completion of daily work assignments by prioritizing and reassigning duties
Other Requirements:
  • Employee in this position may be exposed to blood, body fluids and/or airborne pathogens and is required to wear barriers. .

8 hours shifts as needed Monday - Saturday; On-call rotation for Sundays and Holidays, rotating basis
As needed - 8 hour shifts, 0745 - 1615; Hours may require flexibility based on departmental needs.

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