ZipRecruiter

Log In

1

Utilization Review Manager Jobs in Ohio (NOW HIRING)

syfs

UR Manager

Columbus, OH · On-site

For billing and hospitalization utilization review purposes, the reviewer will identify and certify ... Maintain compliancy with regulation changes affecting utilization management. PositionRequirements ...

Holzer Health System

Lead Case Manager

Gallipolis, OH · On-site

Serves as a clinical expert and resource in Utilization Review and Case Management. Refers potential candidates for early discharge planning to Social Work, Hospice, Home Health or Rehab as ...

Holzer Health System

Lead Case Manager

Gallipolis, OH · On-site

Serves as a clinical expert and resource in Utilization Review and Case Management. Refers potential candidates for early discharge planning to Social Work, Hospice, Home Health or Rehab as ...

previous page

Showing results 41-60

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

Utilization Review Manager information

See Ohio salary details

$37.1K

$86.5K

$159.2K

How much do utilization review manager jobs pay per year?

As of Aug 13, 2026, the average yearly pay for utilization review 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.

Is utilization review a stressful job?

Utilization review managers oversee the assessment of healthcare services to ensure appropriate and efficient care, which can involve high workloads and strict deadlines, leading to stress. The job requires strong organizational skills, attention to detail, and the ability to handle complex cases, which may contribute to job-related stress for some individuals.

What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?

Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.

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

To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.

What is the difference between Utilization Review Manager vs Utilization Review Coordinator?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance companies, healthcare providers, third-party administrators

The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.

What does a utilization review manager do?

A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource 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 Manager jobs in Ohio?

For Utilization Review Manager jobs in Ohio, the most frequently searched job titles are:

What job categories do people searching Utilization Review Manager jobs in Ohio look for?

The top searched job categories for Utilization Review Manager jobs in Ohio are:

What cities in Ohio are hiring for Utilization Review Manager jobs?

Cities in Ohio with the most Utilization Review Manager job openings:

Utilization Review Manager jobs near you
Infographic showing various Utilization Review 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 $86,524 per year, or $41.6 per hour.

RN UTILIZATION SPECIALIST - DENIALS & APPEALS

Southwest General

Middleburg Heights, OH

Full-time

Re-posted 11 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

554th of 1,059 rated hospitals

Job description

Summary

  • POSITION INFORMATION
    • Position summary:Utilization Specialist Denials & Appeals will support the clinical staff, utilization specialists, denials management, and the Physician Advisors. This role will review patient medical records to ensure accurate documentation, proper level of care, and compliance with regulatory standards to prevent denials in the acute care setting.
  • MINIMUM QUALIFICATIONS
    • Education:
      • Bachelors degree in nursing (BSN) preferred

    • Required length and type of experience:
      • Minimum of three years of clinical nursing experience, with strong preference for experience in case management, utilization review, or CDI, in the acute care setting.
      • Knowledge of ICD-10 coding guidelines, Medicare/Medicaid regulations, MCG, Cerner (EMR), MS office tools, such as Word, Excel, PowerPoint.
      • Ability to analyze complex medical records and identify gaps in documentation.
      • Strong verbal and written communication skills to interact with physicians and insurance payers.
      • Ability to collaborate with diverse teams including nurses, physicians, and administrative staff.

    • Required licensure, certification or registry:
      • Current RN License by the Ohio State Board of Nursing.
      • Preferred certification(s): ACM/ACM-RN, CCM, CMAC, CPHQ.

What Southwest General Health Center employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply