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Utilization Manager Jobs in Ohio (NOW HIRING)

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

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

Southwest General

UTILIZATION SPECIALIST

Cleveland, OH · On-site

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

Southwest General

UTILIZATION SPECIALIST

Elyria, OH · On-site

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

Southwest General

UTILIZATION SPECIALIST

Lakewood, OH · On-site

The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patients plan of care. The Utilization Specialists 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

Berea, OH

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

Humana

Utilization Management RN

Columbus, OH · On-site

This role will report directly to the Manager, Utilization Management. Key Responsibilities: Clinical Review: · Conduct comprehensive clinical reviews of prior authorization requests to determine ...

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Ohio

Utilization Manager information

See Ohio salary details

$37.1K

$86.5K

$159.2K

How much do utilization manager jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization manager in Ohio is $86,524.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,600.00 and $104,100.00 per year, depending on experience, location, and employer.

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

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Ohio? The most popular types of Utilization jobs in Ohio are:
What are popular job titles related to Utilization Manager jobs in Ohio? For Utilization Manager jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Utilization Manager jobs in Ohio look for? The top searched job categories for Utilization Manager jobs in Ohio are:
What cities in Ohio are hiring for Utilization Manager jobs? Cities in Ohio with the most Utilization Manager job openings:
What are popular job titles related to Utilization Manager jobs in OH? For Utilization Manager jobs in OH, the most frequently searched job titles are:
Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $86,524 per year, or $41.6 per hour.

UTILIZATION SPECIALIST

Southwest General

Hudson, OH • On-site

Full-time

This job post has expired today. Applications are no longer accepted.

Southwest General Health Center rating

6.9

Company rating: 6.9 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

551st of 1,055 rated hospitals

Job description

Summary

  • POSITION INFORMATION
    • Position summary:
      • The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for acute 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 applied to identify and support patients being placed in the appropriate hospital level of care via emergency, scheduled, or direct admission processes. Combines clinical, business, and regulatory knowledge and skill to reduce significant financial risk and exposure caused by concurrent and retrospective denial of payments for services provided. Through continuous assessments, problem identification, and education, the Utilization Specialist facilitates the quality of health care delivery in the most cost-effective manner. The Utilization Specialist must be able to demonstrate the knowledge and skills necessary to provide services appropriate to age groups according to specific chronological age, developmental age, and/or psycho-social maturity. The Utilization Specialist will work collaboratively with management, staff, and departments involved in the patients plan of care. The Utilization Specialists responsibility is to collect data and clinical review summaries on patients concurrently for both utilization review and quality assessment. The utilization data and clinical summaries are shared with insurance companies to obtain certification of days and prevent denial of payment for services. The Utilization Specialist will communicate with physicians, hospital staff, outside agencies such as insurance companies, and patients regarding the assigned level of care and associated resource utilization.
  • MINIMUM QUALIFICATIONS
    • Education:
      • Graduation from an accredited School of Nursing. BSN graduate preferred.

    • Required length and type of experience:
      • Minimum of five (5) years recent experience in clinical nursing or related nursing field. (e.g. Utilization Review or Case Management)
      • Previous Care Management, Case Management or Utilization Management Experience preferred
      • Previous experience with screening criteria (i.e. Interqual, MCG) preferred
      • Excellent critical thinking and communication skills
      • Strong computer skills

    • Required licensure, certification or registry:
      • Current licensure by Ohio State Board of Nursing.
      • ACM/CCM Certification helpful

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