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Utilization Management Jobs in Ohio (NOW HIRING)

talent4health

RN - Utilization Review

Cleveland, OH · On-site

$2.2K/wk

Previous Care Management, Case Management, or Utilization Management Experience. * Experience with doing 30+ reviews a day. * Previous experience with screening criteria including Cerner, InterQual ...

Nationwide Children's Hospital

Conducts utilization reviews of behavioral health cases to determine medical necessity ... Assists with retrospective reviews and denial management to maintain appropriate and cost-effective ...

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All JobsUtilization Management JobsUtilization Management Jobs in Ohio

Utilization Management information

See Ohio salary details

$37.1K

$85.1K

$155K

How much do utilization management jobs pay per year?

As of Aug 13, 2026, the average yearly pay for utilization management in Ohio is $85,071.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,300.00 and $99,300.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in utilization management, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is utilization management?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a utilization management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

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 Utilization Management jobs in Ohio?

For Utilization Management jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Ohio look for?

The top searched job categories for Utilization Management jobs in Ohio are:

What cities in Ohio are hiring for Utilization Management jobs?

Cities in Ohio with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Ohio as of August 2026, with employment types broken down into 80% Full Time, 13% Part Time, and 7% Contract. Highlights an 93% In-person, and 7% Hybrid job distribution, with an average salary of $85,071 per year, or $40.9 per hour.

RN - Utilization Review

talent4health

Cleveland, OH • On-site

$2.2K/wk

Other

Posted 17 days ago

Job description

Details
Client Name
Southwest General Hospital Center Southwest General Health Center
Job Type
Travel
Offering
Nursing
Profession
RN
Specialty
Utilization Review
Job ID
18807560
Job Title
RN - Utilization Review
Weekly Pay
$2214.0
Shift Details
Shift
8 Hour Flex
Scheduled Hours
40
Job Order Details
Start Date
07/20/2026
End Date
10/19/2026
Duration
13 Week(s)
Job Description
Job Title
RN Utilization Specialist
City/State: Middleburg Heights, Ohio
Shift: 8 Hour Flex, 07:00:00-15:00:00
Contract Length: 12.71 weeks
Start Date: 07/20/2026
Job Description:
Full-Time 40 hours per week, 5 (8) hour shifts 8a-4:30p, as well as every 3rd weekend.
Requirements:
  • Graduation from an accredited School of Nursing. BSN preferred.
  • Current licensure by Ohio State Board of Nursing.
  • Minimum of five (5) years recent experience in clinical nursing or related nursing field.
  • Previous Care Management, Case Management, or Utilization Management Experience.
  • Experience with doing 30+ reviews a day.
  • Previous experience with screening criteria including Cerner, InterQual, and MCG.
  • Excellent critical thinking and communication skills.
  • Strong computer skills.
  • ACM/CCM Certification helpful.

Client Details
Address
18697 Bagley Rd, Middleburg Heights, OH 44130
City
Middleburg Heights
State
OH
Zip Code
44130

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