Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
North Royalton, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
North Royalton, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Westlake, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Westlake, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
North Olmsted, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
North Olmsted, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Cleveland, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Cleveland, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Elyria, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Elyria, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Strongsville, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Strongsville, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Brunswick, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Brunswick, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Beachwood, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Beachwood, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
UTILIZATION SPECIALIST
Hudson, OH · On-site
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
The Utilization Specialist is responsible for carrying out admission and concurrent stay screening reviews of the assigned patient population during the episode of care under defined guidelines for ...
Utilization Review information
See Ohio salary details
$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
How much do utilization review jobs pay per hour?
As of Aug 19, 2026, the average hourly pay for utilization review 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 a utilization review?
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.
What does a utilization review do?
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.
What are the key skills and qualifications needed to thrive in utilization review?
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.
How do I get into a utilization review?
To become a utilization review specialist, typically a healthcare or related degree such as nursing, health administration, or social work is required. Certification in case management or utilization review, like the Certified Professional in Healthcare Quality (CPHQ), can enhance job prospects, and strong analytical and communication skills are essential for success in the role.
Is utilization review a stressful job?
Utilization review is a healthcare role that involves evaluating medical necessity and appropriateness of services, often under strict deadlines and documentation requirements. The job can be stressful due to high workload, the need for accuracy, and managing complex cases, but stress levels vary based on work environment and individual coping skills.
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 jobs in Ohio?
For Utilization Review jobs in Ohio, the most frequently searched job titles are:
- Flex Schedule Remote Utilization Review Nurse
- Utilization Review Physician
- Non Exempt No Experience Utilization Management Nurse
- Night Utilization Review Nurse
- Remote Utilization Review Nurse
- Part Time Utilization Review Nurse
- Per Diem Remote Chart Review Nurse
- Per Diem Utilization Review Nurse
- Evening Optum Health Utilization Review
- Evening Utilization Review Nurse
What job categories do people searching Utilization Review jobs in Ohio look for?
The top searched job categories for Utilization Review jobs in Ohio are:
- Case Manager Utilization Review Nurse
- Chart Utilization Review
- Remote Preservice Review Nurse
- Weekend Utilization Review
- Cigna Utilization Review Nurse
- From Home International Utilization Review Nurse
- Utilization Review Case Manager
- Remote Optum Utilization Review
- Anthem Utilization Review Nurse
- Behavioral Utilization Review
What cities in Ohio are hiring for Utilization Review jobs?
Cities in Ohio with the most Utilization Review job openings:
Job description
Company Description
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Medicaid Division
Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care
Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications
Background
Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience)
Potential for longer term dependent on enrollment
Workers will be doing Concurrent Inpatient Review
MUST have one of the following AT LEAST
-Utilization Review in hospital setting
Nurses who are used to doing both production and review work
Additional Information
All your information will be kept confidential according to EEO guidelines.
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996