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Utilization Management Assistant Jobs in Ohio (NOW HIRING)

Decypher

$44.92/hr

Educate Patient-Centered Medical Home (PCMH) staff on the role of Utilization Management. * Assist the PCMH team in notifying patients admitted to civilian hospitals or civilian emergency departments.

Medix

Medical Assistant

Alliance, OH · On-site

$150 - $210/hr

Job Summary Our client is seeking a proficient Medical Assistant to provide clinical leadership and ... Provide clinical leadership and medical oversight for care management, utilization management, and ...

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All JobsUtilization Management JobsUtilization Management Assistant JobsUtilization Management Assistant Jobs in Ohio

Utilization Management Assistant information

See Ohio salary details

$27.6K

$46K

$66.1K

How much do utilization management assistant jobs pay per year?

As of Sep 15, 2026, the average yearly pay for utilization management assistant in Ohio is $46,010.00, according to ZipRecruiter salary data. Most workers in this role earn between $39,900.00 and $46,100.00 per year, depending on experience, location, and employer.

What is a utilization management assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management assistant?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges utilization management assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

Is utilization management assistant a good job?

Utilization Management Assistants support healthcare organizations by reviewing medical records and authorizations to ensure appropriate care and cost management. The role typically requires attention to detail, knowledge of healthcare policies, and proficiency with electronic health records systems. It can offer stable employment with opportunities for advancement in healthcare administration.

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 cities in Ohio are hiring for Utilization Management Assistant jobs?

Cities in Ohio with the most Utilization Management Assistant job openings:

Infographic showing various Utilization Management Assistant job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 79% Full Time, 16% Part Time, and 4% Contract. Highlights an 80% Physical, 2% Hybrid, and 18% Remote job distribution, with an average salary of $46,010 per year, or $22.1 per hour.

Manager, Utilization Management Medical Director

Cleveland, OH • On-site

Medical Mutual of Ohio
See more jobs at Medical Mutual of Ohioexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 17 days ago

Medical Mutual of Ohio rating

8.6

Company rating: 8.6 out of 10

Based on 17 frontline employees who took The Breakroom Quiz

Job description

Medical Mutual employees must submit their applications through MySource.
This is a hybrid-remote role based out of the Brooklyn, OH office, with the Manager, Utilization Management Medical Director expected to work onsite on four designated in-office days each week.
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.
The Manager, Utilization Management Medical Director opportunity is based at the Medical Mutual corporate headquarters in Brooklyn, OH. This is a hybrid-remote role with the expectation to work onsite on four designated in-office days (Monday-Thursday) each week. This physician leadership role offers the opportunity to lead a team of Associate Medical Directors while remaining clinically engaged through utilization management reviews and strategic quality initiatives. We're particularly interested in physicians with:
• Medicare UM experience
• Medical Director, Associate Medical Director, or Physician Advisor experience
• Interest in leading physician teams and driving operational excellence
The role works closely with senior leadership and plays an important part in Medicare strategy, quality improvement, and provider collaboration.
Job Summary:
Provides leadership to Assistant Medical Director teams based upon specialty or geographic area and performs utilization management review in area of expertise. Fosters continuous improvement in policies, processes, and all parts of the operations.
Responsibilities:
  • Oversee physician's utilization review process and determinations.
  • Participate in quality processes such as audits and quality improvement projects.
  • Provide leadership support to assistant medical directors
  • Ensure physician compliance with clinical goals through monitoring of care management performance.
  • Recommend changes and enhancements to current managed care, review guidelines, and clinical criteria based on clinical knowledge of health care delivery systems, utilization methods, reimbursement methods and treatment protocols.
  • Provide guidance to assistant medical director team in the coordination of quality care.
  • Performs other duties as assigned.

Qualifications:
Education and Experience:
  • MD or DO from an accredited medical school with an active, unrestricted (state) license to practice medicine in United States
  • Minimum of 5 years of established (clinical) care practice experience required
  • Physician reviewer experience in the insurance industry preferred

Professional Certification(s):
  • Board Certification, in nationally recognized specialty (ABMS or AOA) is required.
  • Active Unrestricted license to practice medicine in US

Technical Skills and Knowledge:
  • Foundational windows-based computer skills, including typing, word processing, presentation, and internet research skills.
  • Strong understanding of integration of evidence-based medicine and managed care principles.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
  • We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
  • Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
  • On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
  • Discounts at many places in and around town, just for being a Medical Mutual team member.
  • The opportunity to earn cash rewards for shopping with our customers.
  • Business casual attire, including jeans.

Excellent Benefits and Compensation:
  • Employee bonus program.
  • 401(k) with company match up to 4% and an additional company contribution.
  • Health Savings Account with a company matching contribution.
  • Excellent medical, dental, vision, life and disability insurance - insurance is what we do best, and we make affordable coverage for our team a priority.
  • Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
  • Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
  • After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:
  • Career development programs and classes.
  • Mentoring and coaching to help you advance in your career.
  • Tuition reimbursement up to $5,250 per year, the IRS maximum.
  • Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio; we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
#LI-CS1 #LI-HYBRID
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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