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Remote Utilization Management Jobs in Columbus, OH

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 ...

... utilization management, quality improvement, and clinical operations across Evolent's value-based ... Position is remote with 20% travel expected. To ensure a secure hiring process we have implemented ...

Understanding of field capacity management, labor utilization, scheduling, work order optimization ... (Remote) : It is expected that you will primarily perform work remotely. You may be asked to travel ...

Technical Service Operations Manager

Westerville, OH · On-site

$111K - $112K/yr

... remote tools. * Monitor device utilization within customer environment. * Management of device Installs, Moves, Adds and Changes (IMAC) * Work closely with customer for moves and remodels and make ...

Technical Service Operations Manager

Westerville, OH · On-site

$111K - $112K/yr

... remote tools. * Monitor device utilization within customer environment. * Management of device Installs, Moves, Adds and Changes (IMAC) * Work closely with customer for moves and remodels and make ...

Knowledge of evidenced-based practice and disease management protocols ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...

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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 cities near Columbus, OH are hiring for Remote Utilization Management jobs? Cities near Columbus, OH with the most Remote Utilization Management job openings:
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.
RN Case Manager - Prior Authorization

RN Case Manager - Prior Authorization

Healthcare Support Staffing

Columbus, OH • On-site

$30/hr

Contractor

Posted 17 days ago


Job description

Company Description

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

Position Purpose: Review requests for contract specific prior authorization of services within a centralized unit

  • Review provider request for contract specific prior authorization through fax or telephone with application of evidence based criteria to ensure medical necessity for services
  • Act as clinical resource to unit referral specialist staff and make appropriate referrals
  • Provide provider education as directed
  •  Data entry and inquiry using both claims and clinical system software for performance of the authorization review process with documentation into the appropriate systems
Qualifications
Education/Experience: At least two years clinical nursing experience. Utilization review, prior authorization, or managed care experience preferred.
  • Active OH RN Licensure
  • Experienced with either Interqual or Milliman
Licenses/Certifications: Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred.
Additional Information

Advantages of this Opportunity:

Hours for this Position: Monday- Friday 8a-5p

Pay $30.00 per hour

Start date: 7/6

If you are interested, please call, Lovely 321-574-6539 and email your resume to me.


The greatest compliment to our business is a referral.

If you know of someone looking for a new opportunity, please pass along my contact information! We offer referral bonuses of up to $100.00 for each placement.






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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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