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 ...
Utilization Review Specialist Unique opportunity to join Maryhaven, Central Ohio's largest and most comprehensive behavioral services provider specializing in addiction recovery. We are looking for ...
New
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Utilization Review Specialist Unique opportunity to join Maryhaven, Central Ohio's largest and most comprehensive behavioral services provider specializing in addiction recovery. We are looking for ...
New
Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
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 ...
Utilization Review LVN/RN
Columbus, OH · On-site
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
Utilization Review LVN/RN
Columbus, OH · On-site
Well versed in Utilization Management - Must be able to determine elective vs urgent request with Prior Authorization Review * Provider Claims, Appeals and Denials - certain services require prior ...
Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... WORK ENVIRONMENT Standard office environment with occasional evenings/weekends for events. Hybrid ...
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Monitors and reviews MCO portals to track authorization status, pending requests, approvals ... WORK ENVIRONMENT Standard office environment with occasional evenings/weekends for events. Hybrid ...
The Transplant Nurse, Utilization Review provides the highest level of clinical service both internally and externally to promote quality, medically necessary, cost effective care. Location: This ...
The Transplant Nurse, Utilization Review provides the highest level of clinical service both internally and externally to promote quality, medically necessary, cost effective care. Location: This ...
The Transplant Nurse, Utilization Review provides the highest level of clinical service both internally and externally to promote quality, medically necessary, cost effective care. Location: This ...
The Transplant Nurse, Utilization Review provides the highest level of clinical service both internally and externally to promote quality, medically necessary, cost effective care. Location: This ...
UR Coordinator, Full Time
Columbus, OH · On-site
$24 - $32/hr
About the Role RiverVista is seeking a detail-oriented and knowledgeable Utilization Review (UR) Coordinator to support clinical documentation, insurance authorization processes, and regulatory ...
UR Coordinator, Full Time
Columbus, OH · On-site
$24 - $32/hr
About the Role RiverVista is seeking a detail-oriented and knowledgeable Utilization Review (UR) Coordinator to support clinical documentation, insurance authorization processes, and regulatory ...
UR Manager
Columbus, OH · On-site
For billing and hospitalization utilization review purposes, the reviewer will identify and certify the acute hospitallength of stay authorized for each case. Initiate and maintain medical records ...
UR Manager
Columbus, OH · On-site
For billing and hospitalization utilization review purposes, the reviewer will identify and certify the acute hospitallength of stay authorized for each case. Initiate and maintain medical records ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab plans ongoing until completion * Assess quality and clinical risk issues on a concurrent basis; report ...
RN Case Manager - Prior Authorization
Columbus, OH · On-site
$30/hr
Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.
RN Case Manager - Prior Authorization
Columbus, OH · On-site
$30/hr
Utilization review, prior authorization, or managed care experience preferred. * Active OH RN Licensure * Experienced with either Interqual or Milliman Licenses/Certifications: Current RN, required.
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
The position's objective is to provide high quality customer service in workers' compensation medical case management and utilization review, primarily telephonically.The Nurse Case Manager provides ...
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
The position's objective is to provide high quality customer service in workers' compensation medical case management and utilization review, primarily telephonically.The Nurse Case Manager provides ...
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
The position's objective is to provide high quality customer service in workers' compensation medical case management and utilization review, primarily telephonically.The Nurse Case Manager provides ...
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
The position's objective is to provide high quality customer service in workers' compensation medical case management and utilization review, primarily telephonically.The Nurse Case Manager provides ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
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Utilization review and or discharge planning experience preferred * Excellent verbal and written communication skills * Excellent computer skills. * LMH is accredited by DNV and TJC, and as such, may ...
Weekend Utilization Review information
See Columbus, OH salary details
$20.66 - $24.84
2% of jobs
$24.84 - $29.02
9% of jobs
$31.88 is the 25th percentile. Wages below this are outliers.
$29.02 - $33.20
21% of jobs
The median wage is $36.59 / hr.
$33.20 - $37.38
23% of jobs
$37.38 - $41.56
13% of jobs
$44.81 is the 75th percentile. Wages above this are outliers.
$41.56 - $45.74
10% of jobs
$45.74 - $49.92
8% of jobs
$49.92 - $54.10
5% of jobs
$54.10 - $58.28
5% of jobs
$58.28 - $62.46
2% of jobs
$62.46 - $66.64
2% of jobs
$20
$40
$66
How much do weekend utilization review jobs pay per hour?
As of Sep 2, 2026, the average hourly pay for weekend utilization review in Columbus, OH is $40.84, according to ZipRecruiter salary data. Most workers in this role earn between $32.26 and $46.92 per hour, depending on experience, location, and employer.
What is a weekend utilization review?
A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.
What does a weekend utilization review professional do?
Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.
What are the key skills and qualifications needed to thrive in the weekend utilization review position?
Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.
What are the most commonly searched types of Utilization Review jobs in Columbus, OH?
The most popular types of Utilization Review jobs in Columbus, OH are:
What are popular job titles related to Weekend Utilization Review jobs in Columbus, OH?
For Weekend Utilization Review jobs in Columbus, OH, the most frequently searched job titles are:
- Utilization Review Nurse
- Remote Medical Record Review Nurse
- Remote Utilization Review Nurse
- Remote Utilization Review Social Worker
- Remote Utilization Review Rn
- Part Time Utilization Review Nurse
- No Experience Utilization Review Nurse
- Evening Optum Health Utilization Review
- Weekend Physician Advisor Utilization Review
- Utilization Review Rn
What job categories do people searching Weekend Utilization Review jobs in Columbus, OH look for?
The top searched job categories for Weekend Utilization Review jobs in Columbus, OH are:
- Remote Utilization Review
- Aetna Utilization Review Nurse
- Utilization Review
- Lpn Utilization Review Nurse
- Remote Aetna Utilization Review Nurse
- Remote Anthem Utilization Review Nurse
- Anthem Utilization Review Nurse
- Nurse Practitioner Utilization Review
- Remote Utilization Review Nurse Practitioner
- Remote Dental Utilization Review
What cities near Columbus, OH are hiring for Weekend Utilization Review jobs?
Cities near Columbus, OH with the most Weekend Utilization Review job openings:
Full-time
Re-posted 9 days ago
Nationwide Children's Hospital rating
6.9
Based on 131 frontline employees who took The Breakroom Quiz
551st of 1,064 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:
Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, or equivalent education and experience, required
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
Experience:
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"
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, or equivalent education and experience, 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"
What Nationwide Children's Hospital employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
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