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Utilization Management Jobs in Hamilton, OH (NOW HIRING)

Elevance Health

Utilization Management Representative II

Mason, OH · On-site

$17.33 - $26.59/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Management Representative II Utilization Management Representative II Location: This role enables associates to work virtually full-time, except for required in-person training sessions ...

Elevance Health

Utilization Management Representative II

Mason, OH · On-site

$17.33 - $26.59/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Utilization Management Representative II Utilization Management Representative II Location: This role enables associates to work virtually full-time, except for required in-person training sessions ...

Elevance Health

Wound Care Utilization Management RN

Cincinnati, OH · On-site

$39.34 - $56.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wound Care Utilization Management RN Wound Care Utilization Management RN Virtual : This role enables associates to workvirtually full-time, except for required in-person training sessions, providing ...

Elevance Health

Wound Care Utilization Management RN

Cincinnati, OH · On-site

$39.34 - $56.20/hr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

Wound Care Utilization Management RN Virtual : This role enables associates to workvirtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy.

Premier Health

CASE MANAGER

Middletown, OH

$19 - $24.50/hr

This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource ...

Premier Health

CASE MANAGER

Middletown, OH

$19 - $24.50/hr

This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource ...

Premier Health

CASE MANAGER

Middletown, OH · On-site

$19 - $24.50/hr

This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource ...

Premier Health

CASE MANAGER

Middletown, OH · On-site

$19 - $24.50/hr

This position requires expertise in acute care nursing, healthcare reimbursement requirements, clinical outcome data analysis, utilization management, transition planning and process, resource ...

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Showing results 1-20

All JobsUtilization Management JobsUtilization Management Jobs in Hamilton, OH

Utilization Management information

See Hamilton, OH salary details

$36.3K

$83.3K

$151.8K

How much do utilization management jobs pay per year?

As of Aug 14, 2026, the average yearly pay for utilization management in Hamilton, OH is $83,349.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,100.00 and $97,300.00 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 popular job titles related to Utilization Management jobs in Hamilton, OH?

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

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

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

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

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

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Hamilton, OH as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 15% Part Time, 1% Temporary, and 2% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $83,349 per year, or $40.1 per hour.

Utilization Management (UM) Coordinator

Communicarehealth

Blue Ash, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 21 days ago

Job description

Job Address:

10123 Alliance Road, Sutie 300 Blue Ash, OH 45242


Role: UM Director

Job Post Title: Utilization Review Director

Shift: M-F

Hours: 8-4:30 9-5

The Role Itself

  • Oversees service requests, authorizations and LOS metrics.

  • Reviews documentation quality for clinical effectiveness in regards to reimbursement.

  • Participates in clinical team for goal alignment and compliance.

  • Manages patient transitions between LOC and updates denial log.

  • Develops processes to minimize denials and provides education.

  • Possesses strong knowledge of external review organizations.

  • Facilitates UM team meetings.

Perks with us!

  • Medical Packages with Rx - 3 Choices

  • Flexible Spending Accounts (FSA)

  • Dependent Care Spending Accounts

  • Health Spending Accounts (HSA) with a company match

  • Dental Care Program - 2 choices

  • Vision Plan

  • Life Insurance Options

  • Accidental Insurances

  • Paid Time Off + Paid Holidays

  • Employee Assistance Programs

  • 401k with a Company Match

Education + Leadership Development

  • Up to $15,000 in Tuition Reimbursements

  • Student Loan Forgiveness Programs

Education:

  • Related and relevant field experience

  • Or Bachelor's Degree in Nursing, Social Work, Mental Health/Behavioral Sciences,

  • Or Master's Degree

  • Must be 21 yrs or older

License:

  • LPN, RN, LMSW, LPC, BSW, LSW, LPCC, LISW or applicable license preferred.

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