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Manager Utilization Management Jobs in Columbus, OH

syfs

UR Manager

Columbus, OH

Maintain compliancy with regulation changes affecting utilization management. PositionRequirements Bachelor's degree required. Active RN License from an accredited nursing school Minimum three to ...

Accenture

Clinical Management Manager

Columbus, OH · On-site

$94K - $293K/yr

Design and implement care delivery models, workflows, and utilization management solutions * Drive measurable improvements in patient flow, capacity, LOS, and avoidable utilization * Partner with ...

Accenture

Clinical Management Manager

Hartford, OH · On-site

$94K - $293K/yr

Design and implement care delivery models, workflows, and utilization management solutions * Drive measurable improvements in patient flow, capacity, LOS, and avoidable utilization * Partner with ...

Highmark Health

Senior Pharmacist - Strategy

Columbus, OH · On-site

$54.50 - $65.50/hr

Formulary & Utilization Management Strategy & Development: May lead Highmark's evidence-based medicine drug evaluation program supporting Highmark's formulary and utilization management (UM) and/or ...

Deloitte

Epic Tapestry Specialist

Columbus, OH · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team * Effective written and verbal ...

Deloitte

Epic Tapestry Consultant

Columbus, OH · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Strong desktop skills including Word, Excel, PowerPoint * Work Experience/Direct Knowledge of ...

Deloitte

Epic Tapestry Sr Analyst

Columbus, OH · On-site +1

Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to manage multiple projects and ...

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All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Columbus, OH

Manager Utilization Management information

See Columbus, OH salary details

$37.7K

$87.9K

$161.8K

How much do manager utilization management jobs pay per year?

As of Jun 16, 2026, the average yearly pay for manager utilization management in Columbus, OH is $87,908.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,500.00 and $105,800.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Manager Utilization Management, and why are they important?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a Manager in Utilization Management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a Manager of Utilization Management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are the most commonly searched types of Utilization Management jobs in Columbus, OH? The most popular types of Utilization Management jobs in Columbus, OH are:
What are popular job titles related to Manager Utilization Management jobs in Columbus, OH? For Manager Utilization Management jobs in Columbus, OH, the most frequently searched job titles are:
What job categories do people searching Manager Utilization Management jobs in Columbus, OH look for? The top searched job categories for Manager Utilization Management jobs in Columbus, OH are:
What cities near Columbus, OH are hiring for Manager Utilization Management jobs? Cities near Columbus, OH with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Utilization Management Clinical Specialist

Utilization Management Clinical Specialist

I Am Boundless, Inc.

Columbus, OH • On-site

$72K - $88K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 5 days ago

I Am Boundless rating

8.5

Company rating: 8.5 out of 10

Based on 14 frontline employees who took The Breakroom Quiz

Job description

Want to make an impact? I Am Boundless is hiring for a Utilization Management (UM) Clinical Specialist! Boundless is a non-profit organization specializing in assisting individuals with I/DD and has been serving Ohio for over 40 years. At I Am Boundless, we’re on a mission to build a world that realizes the boundless potential of all people. Join our team, which shares a common passion and purpose in empowering our community.

Benefits – Why Join Boundless?

Financial & Retirement

  • 401(k) Retirement Plan with 5% Employee Matching after Six Months of Employment– Immediately 100% Vested
  • Annual Increases

Paid Time Off

  • 5 Weeks of Paid Time Off
  • 8 Paid Holidays

Health & Wellness

  • Medical Insurance
  • Flexible Benefit Options Including Dental, Vision and Wellness Support
  • Flexible Spending Account (FSA)
  • Dependent Care Account (DCA)
  • Life Insurance & Supplemental Life Insurance
  • Disability Insurance

Professional Support

  • Tuition Discount Opportunities with Schools like Capella University & Franklin University
  • A Qualified Employer for the Federal Public Service Loan Forgiveness (PSLF)
  • Paid Training & Development Opportunities
  • Free CE Courses through Capella University to help Maintain Licensure

Perks & Discounts

  • Employee Assistance Program (EAP) - Counseling, Therapy, Finance, Legal
  • Discount Programs (Ex: Pet Insurance, Movie Tickets, Theme Parks, Costco Membership, etc.)
  • Wellbeing Resources (Up to $50 off Health Insurance Premium Monthly)


What You’ll Do:

As a Utilization Management Clinical Specialist, you’ll play a meaningful role in supporting the organization’s clinical utilization management processes to ensure services are delivered in accordance with medical necessity, regulatory requirements, and payer authorization standards.


This role functions as a clinical decision support partner, working across clinical, supervisory, and revenue cycle teams to monitor service utilization, conduct medical necessity reviews, and facilitate timely authorization processes. The UM Clinical Specialist ensures alignment between clinical practice, documentation integrity, and payer expectations, with a focus on compliance, quality, training and education associated with medical necessity and sustainable service delivery.


This role is critical to ensuring that the organization delivers clinically appropriate, compliant, and financially sustainable services in alignment with evolving Medicaid and payer expectations while supporting system transformation towards value-based care.

Minimum Qualifications:

  • Master’s degree in Social Work, Counseling, Marriage and Family Therapy, or related behavioral health field
  • Independent licensure in the State of Ohio required (LISW, LPCC, or IMFT)
  • Minimum of 3 years of clinical experience in behavioral health services
  • Experience with Medicaid and/or managed care authorization processes strongly preferred
  • Prior experience in utilization management, care coordination, or quality/compliance functions preferred
  • Ability to obtain and maintain First Aid, CPR - adult, child, and infant
  • Experience working with people with autism spectrum disorders and developmental disabilities preferred
  • Valid Ohio Driver's license and insurable driving record
  • Personal vehicle to transport clients as needed
  • Able to pass training to become certified to provide physical intervention as needed
  • Valid driver’s license and insurable driving record, if applicable


Ready to make a difference? Apply today and join a company where you can realize your Boundless potential!

All candidates selected to undergo the pre-employment process will be required to complete a background check, drug screen, and health screen, as applicable for the role.

We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law



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