ZipRecruiter

Log In

1

Remote Utilization Management Jobs in Columbus, OH

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

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 ...

next page

Showing results 1-20

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

Remote Utilization Management information

See Columbus, OH salary details

$20

$40

$66

How much do remote utilization management jobs pay per hour?

As of Jun 12, 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 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 2 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



What I Am Boundless employees say

Pay

Hours and flexibility

Workplace

Get the full story on Breakroom