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 ...
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 ...
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 ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
Akron, OH · On-site
$40K/yr
SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate documentation of services delivered for audit assurances, and positive outcomes regarding effective ...
Akron, OH · On-site
$40K/yr
SUMMARY The Utilization Review Specialist is responsible for proactive planning measures, accurate documentation of services delivered for audit assurances, and positive outcomes regarding effective ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
New
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
New
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...
Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...
Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...
Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Previous utilization review experience in a psychiatric healthcare facility preferred. License: Current unencumbered clinical license strongly preferred. Additional Requirements: CPR certification ...
Cleveland, OH · On-site
$2.2K/wk
Details Client Name Southwest General Hospital Center Southwest General Health Center Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18807560 Job Title RN - ...
Cleveland, OH · On-site
$2.2K/wk
Details Client Name Southwest General Hospital Center Southwest General Health Center Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18807560 Job Title RN - ...
The Utilization Review Specialist is responsible for the authorizations and certifications process for Inpatient and Outpatient Services. This includes the precertification and recertification ...
The Utilization Review Specialist is responsible for the authorizations and certifications process for Inpatient and Outpatient Services. This includes the precertification and recertification ...
This is a utilization review position. Nurses will be responsible for collaborating with healthcare providers and members to promote quality member outcomes to optimize member benefits and to promote ...
This is a utilization review position. Nurses will be responsible for collaborating with healthcare providers and members to promote quality member outcomes to optimize member benefits and to promote ...
Experience with medical record review/utilization review/utilization management Additional Information Are you an experienced Registered Nurse with Utilization review experience looking for a new ...
Experience with medical record review/utilization review/utilization management Additional Information Are you an experienced Registered Nurse with Utilization review experience looking for a new ...
Job Address: 10123 Alliance Road, Suite 320 Blue Ash, OH 45242 New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator for our team in Blue Ash OH! WHO WE ARE The New ...
Job Address: 10123 Alliance Road, Suite 320 Blue Ash, OH 45242 New Vista Health and Wellness is currently recruiting a Utilization Review Coordinator for our team in Blue Ash OH! WHO WE ARE The New ...
Utilization Review or Case Management) * Previous Care Management, Case Management or Utilization Management Experience * Experience with doing 30+ reviews a day * Previous experience with screening ...
Utilization Review or Case Management) * Previous Care Management, Case Management or Utilization Management Experience * Experience with doing 30+ reviews a day * Previous experience with screening ...
Middleburg Heights, OH · On-site
$65/hr
Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 12 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Urgent Hiring - Utilization Management (UM ...
Middleburg Heights, OH · On-site
$65/hr
Utilization Review * Discipline: RN * Start Date: 08/24/2026 * Duration: 12 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Urgent Hiring - Utilization Management (UM ...
We are looking for a Travel Utilization Review RN for a great Travel nursing job in Middleburg Heights, OH. This Utilization Review Travel nursing job pays for 40 hours a week for 13 weeks. With ...
We are looking for a Travel Utilization Review RN for a great Travel nursing job in Middleburg Heights, OH. This Utilization Review Travel nursing job pays for 40 hours a week for 13 weeks. With ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
Utilization review, Resource management, Managing the continuum of care, and Clinical documentation management. Responsible for facilitating appropriate length of stay and reimbursement for all ...
$20.34 - $24.45
2% of jobs
$24.45 - $28.57
9% of jobs
$31.38 is the 25th percentile. Wages below this are outliers.
$28.57 - $32.68
21% of jobs
The median wage is $36.01 / hr.
$32.68 - $36.79
23% of jobs
$36.79 - $40.91
13% of jobs
$44.11 is the 75th percentile. Wages above this are outliers.
$40.91 - $45.02
10% of jobs
$45.02 - $49.13
8% of jobs
$49.13 - $53.25
5% of jobs
$53.25 - $57.36
5% of jobs
$57.36 - $61.48
2% of jobs
$61.48 - $65.59
2% of jobs
$20
$40
$65
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.

Other
Medical, Dental, Vision, Retirement
Posted 4 days ago
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:
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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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.
Recruiting and staffing services
51 - 200 Employees
Omaha, NE, US
2012