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Utilization Management Jobs in Cleveland, OH (NOW HIRING)

Summa Health System

RN Utilization Management

Akron, OH · On-site

$37.40 - $56.11/hr

RN Utilization Management Full-Time Days Akron Campus Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99.

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patient's plan of care. The Utilization Specialist's responsibility is to collect data and ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patient's plan of care. The Utilization Specialist's responsibility is to collect data and ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patient's plan of care. The Utilization Specialist's responsibility is to collect data and ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patient's plan of care. The Utilization Specialist's responsibility is to collect data and ...

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 ...

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All JobsUtilization Management JobsUtilization Management Jobs in Cleveland, OH

Utilization Management information

See Cleveland, OH salary details

$37.8K

$86.8K

$158.1K

How much do utilization management jobs pay per year?

As of Aug 29, 2026, the average yearly pay for utilization management in Cleveland, OH is $86,810.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,600.00 and $101,400.00 per year, depending on experience, location, and employer.

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 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 degree is needed for utilization management?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

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 Utilization Management jobs in Cleveland, OH?

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

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

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

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

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

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Cleveland, OH as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $86,810 per year, or $41.7 per hour.

RN - Utilization Manager

Talented Medical Solutions

Middleburg Heights, OH • On-site

$1.8K - $2.1K/wk

Full-time

Re-posted 7 days ago

Job description

Job Title: RN – Utilization Manager
Location: Middleburg Heights, OH

Schedule:

  • Full-time, 40 hours/week

  • Five 8-hour shifts (8:00a–4:30p)

  • 40 hours not guaranteed; may be low-censused up to one 12-hour shift per pay period

  • Start Date: ASAP or 12/08 (URGENT NEED)

Pay:

  • Local: $47/hr

  • Traveler: $54/hr

Position Details:
Seeking an experienced RN Utilization Manager to support clinical reviews and care coordination in an acute care setting. The ideal candidate will have a strong background in clinical nursing, case management, and utilization management.

Requirements:

  • Minimum 5 years of recent clinical nursing experience

  • Prior Case Management or Utilization Management experience required

  • Experience with screening criteria: Cerner, InterQual, and MCG

  • Active, unencumbered Ohio RN license

  • ACM or CCM certification preferred