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Utilization Review Director Jobs in Ohio (NOW HIRING)

Prime Time Healthcare

Utilization Review

Cleveland, OH · On-site

  • Medical

  • Dental

  • Vision

  • Retirement

Now Hiring: RN Utilization Review - Middleburg Heights, OH Are you a passionate RN professional ... Competitive compensation and weekly direct deposit * Compliance Support Specialist & Onboarding ...

Sevita

Utilization Review Specialist

Akron, OH · On-site

$40K/yr

SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate ... May direct and supervise clerical and administrative staff * Provides feedback on performance ...

Nationwide Children's Hospital

Conducts utilization reviews of behavioral health cases to determine medical necessity ... direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

Southwest General

UTILIZATION SPECIALIST

Hudson, OH · On-site

... direct admission processes. Combines clinical, business, and regulatory knowledge and skill to ... The Utilization Specialist's responsibility is to collect data and clinical review summaries on ...

Southwest General

UTILIZATION SPECIALIST

Hudson, OH

... direct admission processes. Combines clinical, business, and regulatory knowledge and skill to ... The Utilization Specialist's responsibility is to collect data and clinical review summaries on ...

Southwest General

UTILIZATION SPECIALIST

Berea, OH

... direct admission processes. Combines clinical, business, and regulatory knowledge and skill to ... The Utilization Specialists responsibility is to collect data and clinical review summaries on ...

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All JobsUtilization Review JobsUtilization Review Director JobsUtilization Review Director Jobs in Ohio

Utilization Review Director information

See Ohio salary details

$20

$40

$65

How much do utilization review director jobs pay per hour?

As of Aug 12, 2026, the average hourly pay for utilization review director in Ohio is $40.20, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.15 per hour, depending on experience, location, and employer.

What is the difference between Utilization Review Director vs Utilization Review Nurse?

AspectUtilization Review DirectorUtilization Review Nurse
CredentialsRN license, management experience, certifications (e.g., CCM)RN license, certification in case management or utilization review (e.g., CUC)
Work EnvironmentAdministrative, leadership roles overseeing teamsClinical, review of patient cases, direct patient care
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare providers
Search & Comparison IntentLeadership, management, strategic planning in utilization reviewClinical review, case assessment, patient care coordination

The Utilization Review Director typically oversees review teams and manages utilization strategies, requiring leadership skills and management experience. In contrast, the Utilization Review Nurse focuses on clinical case assessments and patient care reviews. Both roles require RN licensure and relevant certifications but differ mainly in scope and responsibilities.

What does a utilization review director do?

A Utilization Review Director oversees the evaluation of medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead teams that review patient care requests, manage compliance with regulations, and implement strategies to ensure cost-effective care without compromising quality. Their responsibilities often include policy development, data analysis, and collaboration with healthcare providers to optimize resource use and improve patient outcomes.

Is utilization review a stressful job?

Utilization Review Directors often work in high-pressure environments where they must make quick, accurate decisions regarding healthcare services. The role can be stressful due to the need to balance patient care, insurance policies, and regulatory compliance, but stress levels vary based on workload, organizational support, and experience. Strong analytical skills and certification in utilization review can help manage job demands effectively.

What degree do I need for utilization review director?

A utilization review director typically needs at least a bachelor's degree in healthcare administration, nursing, or a related field. Many employers prefer candidates with a master's degree such as an MBA or a healthcare-related advanced degree, along with relevant experience and certifications like the Certified Professional in Healthcare Quality (CPHQ).

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

A Utilization Review Director often navigates challenges such as balancing regulatory compliance with organizational goals, managing interdisciplinary teams, and keeping up with evolving healthcare policies. Staying proactive with ongoing education, fostering open communication among staff, and implementing efficient review processes can help address these issues. Additionally, leveraging data analytics and technology streamlines case reviews and ensures evidence-based decision-making, ultimately improving both patient outcomes and operational efficiency.

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

To thrive as a Utilization Review Director, you need a deep understanding of clinical guidelines, healthcare regulations, and case management principles, typically supported by a nursing or related healthcare degree and relevant licensure. Familiarity with utilization management software, electronic health records (EHR), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) is common in the field. Strong leadership, communication, analytical thinking, and decision-making skills help you effectively manage teams and ensure compliance. These competencies ensure efficient resource use, regulatory adherence, and high-quality patient outcomes within healthcare organizations.
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 cities in Ohio are hiring for Utilization Review Director jobs? Cities in Ohio with the most Utilization Review Director job openings:
Utilization Review Director jobs near you

Utilization Review

Prime Time Healthcare

Cleveland, OH • On-site

Other

Medical, Dental, Vision, Retirement

Posted 8 days ago

Job description

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 team in Middleburg Heights, OH and make a real impact in patient care!

In this role, you'll be at the forefront of healthcare, delivering top-notch care with precision and compassion. As an integral part of our team, you'll collaborate closely with fellow healthcare professionals, ensuring every patient receives the highest level of care possible.

If you're ready to elevate your career and make a difference in the lives of others, apply today!

At Prime Time Healthcare, we offer competitive compensation along with a large range of benefits including:

  • Competitive compensation and weekly direct deposit
  • Compliance Support Specialist & Onboarding Assistance
  • Dedicated recruiter for personalized support
  • Paid, safe, pet-friendly lodging (if applicable)
  • Round-the-clock customer support 24/7
  • Unlimited referral bonus up to $750
  • Medical, Vision & Dental insurance
  • 401(k) Matching Program
  • Flexible Schedules
  • Travel Discounts

Prime Time Healthcare, LLC is an Equal Opportunity Employer (EOE).

*Estimated pay and benefits packages are on a per facility basis and may change with market conditions. Exact pay and benefits package will be negotiated with Prime Time Healthcare and may vary with several factors including but not limited to, guaranteed hours, travel distance, demand, eligibility, etc.

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About PrimeTime Healthcare

Sourced by ZipRecruiter

PrimeTime Healthcare, based in Omaha, NE, US, is a leading provider of staffing solutions in the healthcare industry. According to information accessed from their official website, primetimehealthcare.com, the company specializes in placing high-quality healthcare professionals into temporary and travel positions across a vast network of healthcare facilities nationwide. Founded in 2012, PrimeTime Healthcare quickly established a reputation for customer-focused and result-oriented services, earning it a place on Staffing Industry Analyst’s fastest-growing staffing companies list.

Industry

Recruiting and staffing services

Company size

51 - 200 Employees

Headquarters location

Omaha, NE, US

Year founded

2012

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