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Weekend Supervisor Utilization Management Jobs in Ohio

Nationwide Children's Hospital

Assists with retrospective reviews and denial management to maintain appropriate and cost-effective ... right of any supervisor to assign, direct, and control the work of employees under their ...

Medilodge

RN Weekend Supervisor - Part-Time

Toledo, OH · On-site

Part-Time Registered Nurse Weekend Supervisor (RN) Facility: Arbors at Sylvania Are you a RN ... The Unit Manager Registered Nurse is responsible for directing the entire operation of a nursing ...

Akron Children's Hospital

Payer Policy Coordinator

Akron, OH · On-site

$18.50 - $24.75/hr

... utilization management required. Experience in a children's hospital, pediatric specialty practice, or managed care environment is strongly preferred. 5. Years of supervisory experience: None ...

OhioHealth

Case Manager Extender

Cambridge, OH · On-site

... utilization management and care coordination team. 5. Monitor commercial payers accounts, to ... Office Supervisor and or Manager, to include but not limited to: faxing dictation to referring ...

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Weekend Supervisor Utilization Management information

What are the primary challenges a weekend supervisor in utilization management faces, and how can they be addressed?

Weekend Supervisors in Utilization Management often encounter challenges such as limited staff availability, high patient volume, and the need for rapid decision-making with less direct access to physicians or ancillary services. To address these, strong organizational skills, proactive communication, and the ability to prioritize urgent cases are essential. Supervisors should foster a collaborative atmosphere, leverage digital tools for efficient workflow, and ensure clear escalation protocols for complex cases, all while maintaining regulatory compliance and quality patient care.

What are the key skills and qualifications needed to thrive as a weekend supervisor in utilization management, and why are they important?

To thrive as a Weekend Supervisor Utilization Management, you need a comprehensive understanding of clinical guidelines, utilization review processes, and healthcare regulations, typically supported by a nursing degree (RN) or related clinical licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of relevant accreditation standards (such as URAC or NCQA) are essential. Strong leadership, decision-making, and effective communication skills help navigate team dynamics and complex case reviews during weekend shifts. These skills ensure efficient resource management, compliance with healthcare standards, and consistent quality of care even outside regular business hours.

What is the difference between Weekend Supervisor Utilization Management vs Weekend Utilization Review Coordinator?

AspectWeekend Supervisor Utilization ManagementWeekend Utilization Review Coordinator
CredentialsTypically requires a healthcare-related license or certification (e.g., RN, LPN, or case management certification)Often requires similar healthcare credentials, such as RN or case management certification
Work EnvironmentSupervises utilization management staff, oversees case reviews, and ensures compliance during weekendsPerforms case reviews, evaluates medical necessity, and coordinates utilization decisions during weekends
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance providers, healthcare organizations

The main difference is that the Weekend Supervisor Utilization Management role involves supervising staff and managing utilization processes, while the Weekend Utilization Review Coordinator focuses on conducting case reviews and making utilization decisions during weekends. Both roles require healthcare credentials and operate within similar environments, but their responsibilities differ in scope and leadership level.

What does a weekend supervisor in utilization management do?

A Weekend Supervisor in Utilization Management oversees the review and coordination of patient care services during weekends to ensure appropriate use of healthcare resources. They manage a team of utilization review staff, ensure compliance with policies, and facilitate communication between healthcare providers and insurance companies. Their role is critical in making timely decisions about patient admissions, continued stays, and discharges, focusing on quality care and cost efficiency. They also handle escalations and provide support to staff working outside of regular business hours.
What are the most commonly searched types of Supervisor Utilization Management jobs in Ohio? The most popular types of Supervisor Utilization Management jobs in Ohio are:
What are popular job titles related to Weekend Supervisor Utilization Management jobs in Ohio? For Weekend Supervisor Utilization Management jobs in Ohio, the most frequently searched job titles are:
What job categories do people searching Weekend Supervisor Utilization Management jobs in Ohio look for? The top searched job categories for Weekend Supervisor Utilization Management jobs in Ohio are:
What cities in Ohio are hiring for Weekend Supervisor Utilization Management jobs? Cities in Ohio with the most Weekend Supervisor Utilization Management job openings:
Weekend Supervisor Utilization Management jobs near you
Infographic showing various Weekend Supervisor Utilization Management job openings in Ohio as of July 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Utilization Review Specialist - Autism

Nationwide Children's Hospital

Hybrid

Full-time

Posted 17 days ago

Nationwide Children's Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 131 frontline employees who took The Breakroom Quiz

551st of 1,055 rated hospitals

Job description

Overview:


Schedule: Monday-Friday (8:00am-4:30pm)

Position is work from home after a 90 day in-office training period.


Job Description Summary:


Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.


Job Description:


Essential Functions:

  • 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-party payors to ensure the delivery of quality care and optimum payment.
  • Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
  • Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
  • Provides education and support regarding utilization review and management activities and processes.
  • Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
  • Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.


Education Requirement:

Bachelor's Degree in Social Work, Psychology, or related field, required.


Licensure Requirement:

(not specified)


Certifications:

(not specified)


Skills:

  • Excellent written and verbal communication and interpersonal skills.
  • Excellent customer service and organizational skills.
  • Working knowledge of CMS and other review agency standards.
  • Proficient with software applications including CM, payer web applications, MITS, and others.


Experience:

  • Three years of behavioral health experience, required.
  • One year of experience in pediatric care or services, required.
  • Utilization review or utilization management experience, preferred.


Physical Requirements:

OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel

FREQUENTLY: Standing, Walking

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting


Additional Physical Requirements performed but not listed above:

(not specified)




"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

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About Nationwide Children's Hospital

Sourced by ZipRecruiter

Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Columbus, OH, US

Year founded

1892

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