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Utilization Manager Jobs in Cleveland, OH (NOW HIRING)

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

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

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 ...

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.

Prime Time Healthcare

Utilization Review

Cleveland, OH · On-site

Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our ...

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Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Cleveland, OH

Utilization Manager information

See Cleveland, OH salary details

$37.8K

$88.1K

$162.2K

How much do utilization manager jobs pay per year?

As of Sep 8, 2026, the average yearly pay for utilization manager in Cleveland, OH is $88,131.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,600.00 and $106,000.00 per year, depending on experience, location, and employer.

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 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 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

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

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

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

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

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

Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Cleveland, OH as of August 2026, with employment types broken down into 85% Full Time, 12% Part Time, and 3% Contract. Highlights an 84% Physical, 2% Hybrid, and 14% Remote job distribution, with an average salary of $88,293 per year, or $42.4 per hour.

MANAGER OF UTILIZATION REVIEW

Southwest General

Beachwood, OH • On-site

Full-time

Posted 7 days ago

Southwest General Health Center rating

6.9

Company rating: 6.9 out of 10

Based on 46 frontline employees who took The Breakroom Quiz

543rd of 1,066 rated hospitals

Job description

Summary

  • POSITION INFORMATION
    • Position summary:
      • The Utilization Management (UM) RN Manager is responsible for the day-to-day leadership, operational oversight, and performance management of the Utilization Management nursing team. Reporting to the UM RN Director, the Manager translates department strategy, regulatory and payer requirements, approved clinical review criteria, and organizational priorities into consistent daily execution.
      • The role provides direct supervision, coaching, workflow management, clinical-operational support, and performance oversight for assigned UM staff. The Manager collaborates with physician advisors/medical directors, case management, clinical operations, revenue cycle, payer relations, quality, compliance, and other stakeholders to support timely, accurate, evidence-informed utilization management decisions and appropriate stewardship of healthcare resources.
  • MINIMUM QUALIFICATIONS
    • Education:
      • Bachelor of Science in Nursing (BSN) required, or equivalent qualification consistent with organizational policy.
      • Masters degree in Nursing, Healthcare Administration, Business Administration, Public Health, or a related field preferred.

    • Required length and type of experience:
      • Five or more years of progressive clinical nursing and/or utilization management experience preferred, including three or more years of experience in utilization management, utilization review, case management, managed care, or a closely related function.
      • Prior formal leadership experience required; two or more years of supervisory or management experience preferred.

    • Required licensure, certification or registry:
      • Current Ohio State Board of Nursing license required.
      • Certified Case Manager (CCM) certification preferred.
      • Accredited Case Manager (ACM) certification preferred.
    • Core Knowledge, Skills, and Competencies
      • Knowledge of utilization management and utilization review principles, including prospective, concurrent, and retrospective review.
      • Knowledge of medical necessity, patient status, level-of-care review, authorization processes, payer requirements, denial prevention, and escalation pathways.
      • Knowledge of evidence-based clinical review criteria and appropriate use of clinical decision-support tools.
      • Knowledge of regulatory and accreditation requirements affecting utilization management and clinical review.
      • Demonstrated ability in people leadership, coaching, performance management, conflict resolution, and change management.
      • Demonstrated ability to interpret operational analytics and KPIs, conduct root-cause analysis, and drive process improvement.
      • Demonstrated ability to communicate effectively across interdisciplinary teams, including nursing, physicians, physician advisors, payers, revenue cycle, and leadership.
      • Demonstrated application of professional nursing judgment, ethical practice, confidentiality, and appropriate stewardship of healthcare resources.

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