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Remote Utilization Management Jobs in Columbus, OH

Integrated Resources INC

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 ...

Pharmacy Careers

Appeals Pharmacist (Remote)

Columbus, OH · On-site +1

$55.25 - $67.25/hr

Prior managed care or utilization management experience preferred - retail and hospital pharmacists ... Many roles offer hybrid or fully remote options. * Rewards: Competitive salary, comprehensive ...

syfs

UR Manager

Columbus, OH · On-site

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

Deloitte

Epic Tapestry Consultant

Columbus, OH · On-site +1

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

Deloitte

Epic Tapestry Specialist

Columbus, OH · On-site +1

Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Ability to work independently and collaborate as part of a team

Deloitte

Epic Tapestry Sr Analyst

Columbus, OH · On-site +1

Role is remote Preferred * Work Experience/Direct knowledge of Utilization Management or Tapestry Utilization Management build * Analytical/ Decision Making Responsibilities * Analytical ability to ...

Sedgwick

RN Utilization Review

Columbus, OH · On-site

$73K - $75K/yr

To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive ...

CVS Health

Case Manager, Registered Nurse

Columbus, OH · Remote

$54K - $155K/yr

Position Summary This is a remote work from home role anywhere in the US with virtual training ... Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization ...

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All JobsRemote Utilization Management JobsRemote Utilization Management Jobs in Columbus, OH

Remote Utilization Management information

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$66

How much do remote utilization management jobs pay per hour?

As of Jun 11, 2026, the average hourly pay for remote utilization management 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.

How does a Remote Utilization Management professional typically collaborate with healthcare providers and insurance teams?

Remote Utilization Management professionals frequently interact with both healthcare providers and insurance teams through secure digital platforms, phone calls, and virtual meetings. They review patient records, assess the necessity of medical services, and communicate their recommendations or authorization decisions. Effective collaboration requires clear documentation, timely responses, and strong communication skills to ensure that care is both medically appropriate and cost-effective. While the work is often independent, regular coordination with interdisciplinary teams is essential for maintaining high-quality patient outcomes and adhering to regulatory standards.

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

Success as a Remote Utilization Management Nurse requires a registered nursing license, clinical experience, and strong knowledge of medical necessity criteria and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and case management systems is typically necessary. Exceptional communication, critical thinking, and organizational skills help professionals excel in evaluating cases and coordinating with providers remotely. These skills are crucial for ensuring appropriate care, cost-effective resource use, and regulatory compliance in a remote healthcare setting.

What is remote utilization management?

Remote utilization management is a process in which healthcare professionals, such as nurses or case managers, review and assess the necessity, efficiency, and appropriateness of medical services—often from a remote location. These professionals typically work for insurance companies, hospitals, or healthcare organizations to ensure that patients receive the right care while controlling costs. By working remotely, they use electronic health records, phone calls, and other digital tools to collaborate with providers and patients. This role helps improve healthcare quality and cost-effectiveness while allowing employees flexible work arrangements.

What is the difference between Remote Utilization Management vs Remote Case Management?

AspectRemote Utilization ManagementRemote Case Management
CredentialsRN, LPN, or licensed healthcare professionalsRN, LPN, or social workers
Work EnvironmentHealthcare facilities, insurance companies, telehealthHealthcare providers, insurance, community agencies
Industry UsageInsurance, healthcare, telehealthHealthcare, social services, insurance
Primary FocusReviewing medical necessity, authorizationsCoordinating patient care, support services

Remote Utilization Management primarily involves reviewing medical necessity and authorizations, while Remote Case Management focuses on coordinating patient care and support services. Both roles require healthcare credentials and are used within healthcare and insurance industries, but they serve different functions in patient care and resource allocation.

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 Remote Utilization Management jobs in Columbus, OH? For Remote Utilization Management jobs in Columbus, OH, the most frequently searched job titles are:
What job categories do people searching Remote Utilization Management jobs in Columbus, OH look for? The top searched job categories for Remote Utilization Management jobs in Columbus, OH are:
What cities near Columbus, OH are hiring for Remote Utilization Management jobs? Cities near Columbus, OH with the most Remote Utilization Management job openings:
Remote Utilization Management jobs near you
Infographic showing various Remote Utilization Management job openings in Columbus, OH as of June 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution, with an average salary of $84,947 per year, or $40.8 per hour.
Utilization Review LVN/RN

Utilization Review LVN/RN

Healthcare Support Staffing

Columbus, OH

Full-time

Posted 8 days ago

Job description

Company Description

Why You Should Work For Us:

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description
  • Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
  • Analyzes clinical service requests from members or providers against evidence based clinical guidelines.
  • Conducts prior authorization reviews to determine financial responsibility
Qualifications
  • 2 years Inpatient background with Hospital Nursing (Med-Surg, ER)
  • 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 authorization (PA) from the Utilization Management (UM) department
  • 6 + months of Interqual experience
  • 6+ months of Coding with ICD10 and CPT/ HCPCS
Additional Information

Interested in being considered? 

If you are interested in applying to this position, please click the Green I'm Interested Button to email your resume and contact Jeff St Louis 407-478-0332x223. 


Healthcare Support logo

About Healthcare Support

Sourced by ZipRecruiter

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Industry

Recruiting and staffing services

Company size

201 - 500 Employees

Headquarters location

Maitland, FL, US

Year founded

2003

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