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Utilization Review Assistant Jobs in Ohio (NOW HIRING)

Kettering Health Network

$250 - $350/hr

... assist in the development and implementation of the hospital's Strategic Plan. * Utilization Review: Oversee and provide clinical supervision of the hospital's utilization review program.

Aultman Health Foundation

PHARMACIST - AULTCARE

Canton, OH · On-site

$51 - $61.50/hr

... utilization review, dose optimization, and reviewing prescriber patterns. * Oversee aspects of the ... assist in emergency care or first aid or to be potentially exposed in some other way.

New

Aultman Health Foundation

PHARMACIST - AULTCARE

Canton, OH · On-site

$54.50 - $65.50/hr

... utilization review, dose optimization, and reviewing prescriber patterns. * Oversee aspects of the ... assist in emergency care or first aid or to be potentially exposed in some other way.

Aultman Health Foundation

PHARMACIST - AULTCARE

Canton, OH · On-site

$54.50 - $65.50/hr

... utilization review, dose optimization, and reviewing prescriber patterns. * Oversee aspects of the ... assist in emergency care or first aid or to be potentially exposed in some other way.

Aultman Health Foundation

PHARMACIST - AULTCARE

Canton, OH · On-site

$54.50 - $65.50/hr

... utilization review, dose optimization, and reviewing prescriber patterns. * Oversee aspects of the ... assist in emergency care or first aid or to be potentially exposed in some other way.

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Showing results 21-40

All JobsUtilization Review JobsUtilization Review Assistant JobsUtilization Review Assistant Jobs in Ohio

Utilization Review Assistant information

See Ohio salary details

$9

$28

$58

How much do utilization review assistant jobs pay per hour?

As of Aug 8, 2026, the average hourly pay for utilization review assistant in Ohio is $28.29, according to ZipRecruiter salary data. Most workers in this role earn between $16.04 and $34.72 per hour, depending on experience, location, and employer.

What is a utilization review assistant?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What skills and qualifications are needed to be a utilization review assistant?

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

What does a utilization review assistant do?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

What are the most commonly searched types of Utilization Review jobs in Ohio? The most popular types of Utilization Review jobs in Ohio are:
What are popular job titles related to Utilization Review Assistant jobs in Ohio? For Utilization Review Assistant jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Utilization Review Assistant jobs in Ohio look for? The top searched job categories for Utilization Review Assistant jobs in Ohio are:
What cities in Ohio are hiring for Utilization Review Assistant jobs? Cities in Ohio with the most Utilization Review Assistant job openings:
Utilization Review Assistant jobs near you
Infographic showing various Utilization Review Assistant job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $58,838 per year, or $28.3 per hour.

Registered Nurse - Utilization Manager

Decypher

Dayton, OH • On-site

$44.92/hr

Full-time

Re-posted 2 days ago

Job description

Join Decypher and make a direct impact on the health and readiness of America's service members, veterans, and their families. Since 2008 Decypher has offered healthcare industry professionals careers where their expertise is valued, and their work makes a meaningful impact. Decypher partners with the Defense Health Agency to deliver professional services, technology, and management solutions. Our mission is to provide and support quality care for our veterans, servicemembers and their families, across the United States.
Job Summary: The Registered Nurse - Utilization Manager must have the ability to sit or stand for extended periods while reviewing medical records and working on a computer, with frequent use of standard office equipment and clear verbal and written communication. Must have sufficient visual acuity and attention to detail to analyze complex clinical documentation, with occasional ability to move about the workplace and lift up to 10-15 pounds.
Required Qualifications:
  • Education:
    • Associate degree (ADN) or
    • Bachelor of Science in Nursing (BSN) from a program accredited by a national nursing accrediting agency recognized by the U.S. Department of Education.
  • Certifications:
    • Basic Life Support (BLS)
  • License: Valid, Active, Unrestricted Registered Nurse License
  • Experience:
    • 4 years of experience if ADN holder; 2 years of experience if BSN holder - in discharge planning or case management.
    • Full-time employment in a nursing field within the last 36 months is required.

U.S. Citizenship is required
Key Responsibilities:
  • Assist with inpatient discharge planning as needed, including home safety patient/family
  • interviews, attending morning planning meetings, and coordinating transfers, home durable medical equipment, home care services, inpatient rehabilitation, and skilled care.
  • Develop and implement a comprehensive Utilization Management (UM) program aligned with Military Treatment Facility (MTF), Air Force (AF), and Defense Health Agency (DHA) goals and objectives.
  • Collect, analyze, and trend data/metrics on program areas to identify over- and underutilization of healthcare resources, inefficiencies, and areas for cost containment. Provide reports, feedback, and recommendations in a timely manner.
  • Monitor specialty care referrals, ensuring appropriateness, covered benefits, and authorization for medical procedures, laboratory, radiology, and pharmacy services.
  • Evaluate clinical practice patterns and trends, providing feedback to the Chief of Hospital
  • Services (SGH) and clinical teams.
  • Identify and refer potential cases to Disease Management, Case Management, Discharge
  • Planning, and the Deployment Availability Working Group.
  • Participate in Medical Management, Population Health Working Group, and care coordination meetings as assigned.
  • Conduct nursing peer reviews as assigned.
  • Educate Patient-Centered Medical Home (PCMH) staff on the role of Utilization Management.
  • Assist the PCMH team in notifying patients admitted to civilian hospitals or civilian emergency departments.
  • Perform medical necessity reviews, including concurrent reviews for length of stay (LOS) using approved clinical decision tools. Assess medical necessity of services and communicate negative trends to the Chief of the Medical Staff.
  • Navigate electronic health records and TRICARE managed care contractor sites.
  • Act as referral approval authority for designated referrals based on MTF/AF/DHA national
  • guidance and standards, including processing and validating durable medical equipment referrals for PRIME beneficiaries and authorizing Supplemental Health Care Program (SHCP) funds for active-duty beneficiaries.
  • Refer all first-level review failures to SGH or designated points of contact for further review and disposition.
  • Verify beneficiary eligibility using the Defense Eligibility Enrollment Reporting System
  • (DEERS). Obtain pertinent patient information and update electronic medical records, local referral databases, and other office automation systems as needed.
  • Perform other duties as assigned.

Work Environment & Schedule: Monday - Friday; 8 hour shifts 7:00am - 16:30 with a 30-minute uncompensated lunch.
Compensation & Benefits: $44.92 per hour + $4.93 H&W IF APPLICABLE
Physical requirements:
Decypher is an equal opportunity and affirmative action employer committed to a diverse and inclusive workforce (M/F/D/V)

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