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Utilization Review Case Manager Jobs in Ohio (NOW HIRING)

Sheakley

RN Case Manager

Columbus, OH · On-site

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...

Sheakley

RN Case Manager

Columbus, OH · On-site

Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...

LMHS

RN Case Manager - Case Management

Newark, OH · On-site

RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...

LMHS

RN Case Manager - Case Management

Newark, OH · On-site

RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...

Encompass Health

Case Manager

Dayton, OH · On-site

$19.50 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health

Case Manager

Westerville, OH

$19.25 - $24.75/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:

Encompass Health Corporation

Case Manager

Westerville, OH · On-site

$19.50 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications • License or ...

Encompass Health

Case Manager

Dayton, OH · On-site

$19.50 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

Encompass Health Corporation

Case Manager

Dayton, OH · On-site

$19.50 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...

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Showing results 41-60

All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Ohio

Utilization Review Case Manager information

See Ohio salary details

$15

$34

$57

How much do utilization review case manager jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for utilization review case manager in Ohio is $34.69, according to ZipRecruiter salary data. Most workers in this role earn between $28.12 and $36.59 per hour, depending on experience, location, and employer.

What are some common challenges utilization review case managers face when coordinating care across multiple departments?

Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.

What is a utilization review case manager?

A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.

What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing medical records, clinical review, patient care evaluation

Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.

What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?

To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.
What are popular job titles related to Utilization Review Case Manager jobs in Ohio? For Utilization Review Case Manager jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Utilization Review Case Manager jobs in Ohio look for? The top searched job categories for Utilization Review Case Manager jobs in Ohio are:
What cities in Ohio are hiring for Utilization Review Case Manager jobs? Cities in Ohio with the most Utilization Review Case Manager job openings:
Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Ohio as of August 2026, with employment types broken down into 1% As Needed, 85% Full Time, 10% Part Time, and 4% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution, with an average salary of $72,149 per year, or $34.7 per hour.

RN Case Manager

Sheakley

Columbus, OH • On-site

Full-time

Posted 18 days ago

Job description

Job Summary: The Case Manager serves as the primary clinical contact for injured workers, coordinating care and facilitating safe, timely return-to-work outcomes. This role involves assessing treatment plans, collaborating with medical providers, employers, and insurers, and ensuring quality, compliance, and effective communication across all parties. The Case Manager must exercise strong clinical judgment, organizational skills, and maintain confidentiality.

QUALIFICATIONS:

  • A current, unrestricted Ohio state licensure or certification in a health or human services discipline that allows the professional to conduct an assessment independently as permitted within the scope of practice of the discipline
  • Eligibility to hold a multi-state licenses as needed to meet the needs of the company
  • Two years full-time equivalent of direct clinical care to the consumer and
  • Prefer a minimum of one (1) year of active case management experience in worker's compensation
  • Maintains continuing education as required to maintain licensure and certification
  • Excellent leadership, verbal/written communication skills, strong organizational skills, and excellent decision making and judgment

ROLE AND RESPONSIBILITIES FOR THE CASE MANAGER:

  • Reports directly to The Case Management Team Lead
  • Serve as the first point of post-injury contact after triage, developing and managing return to work opportunities with injured workers, designated network providers, and employer contacts
  • Assess the appropriateness of the level of care, diagnostic tests and clinical procedures for utilization review on a concurrent basis
  • Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion
  • Assess quality and clinical risk issues on a concurrent basis; report any recognized issue to the Case Management Team Lead
  • Assess documentation of medical records for completeness on a concurrent basis
  • Ability to obtain and interpret information appropriate to injured workers' needs as required for assessment, treatment, and patient care services
  • Assess, develop, implement and monitor plan of care;
  • Initiate communication and consistently communicate with the injured worker, employer, provider, BWC, and TPA (five-point contact, which could include attorney for IW/employer)
  • Provide education and guidance to all parties to the claim; this includes: claim review at staffings, and/or providing direction to any member of the five-point contact
  • Develop and maintain a positive work atmosphere and support overall team; demonstrate ability to work within a team structure
  • Practice capable and effective problem identification and resolution skills as a method of sound decision making
  • Maintain confidentiality
  • Work independently, efficiently, and deal with priorities
  • Understand and uphold UniComp philosophy and demonstrate commitment to UniComp's core values: have a sense of urgency, be optimistic, promote independence, and respect human dignity
  • Perform other duties as assigned
  • Practice nursing within the Scope of Practice as designated by the State of Ohio Board of Nursing
  • Employee may be asked to travel from time to time to attend employer meetings or other offsite functions.