Licensure/ Certification: RN License through the State of Ohio * Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management ...
Licensure/ Certification: RN License through the State of Ohio * Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management ...
Clinical Financial Case Mgr - RN
Columbus, OH · On-site +1
The CFCM-RN maintains an awareness of State and National Health care trends, JCAHO, CMS, and third-party payer Utilization Management guidelines. The Financial aspect of the role involves acquiring ...
Clinical Financial Case Mgr - RN
Columbus, OH · On-site +1
The CFCM-RN maintains an awareness of State and National Health care trends, JCAHO, CMS, and third-party payer Utilization Management guidelines. The Financial aspect of the role involves acquiring ...
License Practical Nurse
Columbus, OH · On-site
$24.75 - $33.75/hr
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Completion of an accredited Registered Nursing program. (a combination of experience and education ...
License Practical Nurse
Columbus, OH · On-site
$24.75 - $33.75/hr
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Completion of an accredited Registered Nursing program. (a combination of experience and education ...
Utilization Review LVN/RN
Columbus, OH · On-site
... Nursing (Med-Surg, ER ... Well versed in Utilization Management - Must be able to determine elective vs urgent request with ...
Utilization Review LVN/RN
Columbus, OH · On-site
... Nursing (Med-Surg, ER ... Well versed in Utilization Management - Must be able to determine elective vs urgent request with ...
Care Review Clinician
Columbus, OH · On-site
Minimum 3-4 years of clinical practice in hospital setting. • 1+ year utilization management, and/or case management. • Required Licensure/Certification: Active, unrestricted State Nursing (RN) ...
Care Review Clinician
Columbus, OH · On-site
Minimum 3-4 years of clinical practice in hospital setting. • 1+ year utilization management, and/or case management. • Required Licensure/Certification: Active, unrestricted State Nursing (RN) ...
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 ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
Maintain compliancy with regulation changes affecting utilization management. PositionRequirements Bachelor's degree required. Active RN License from an accredited nursing school Minimum three to ...
Maintain compliancy with regulation changes affecting utilization management. PositionRequirements Bachelor's degree required. Active RN License from an accredited nursing school Minimum three to ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
Care Review Clinician
Columbus, OH · On-site
Minimum 3-4 years of clinical practice in hospital setting. 1+ year utilization management, and/or case management. Required Licensure/Certification: Active, unrestricted State Nursing (RN) license ...
Care Review Clinician
Columbus, OH · On-site
Minimum 3-4 years of clinical practice in hospital setting. 1+ year utilization management, and/or case management. Required Licensure/Certification: Active, unrestricted State Nursing (RN) license ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
... case management, utilization management of inpatient admissions, and transitions of care to ... Current licensure as a registered nurse in the state of Ohio is required. * Valid Ohio driver ...
Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...
Care Review Nurse
Columbus, OH · On-site
Works with the Utilization Management team primarily responsible for inpatient medical necessity ... Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses ...
RN Case Manager - Prior Authorization
Columbus, OH · On-site
$30/hr
Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred. Additional Information Advantages of this Opportunity: Hours for this ...
RN Case Manager - Prior Authorization
Columbus, OH · On-site
$30/hr
Current RN, required. Utilization Management (CPUR) certification, Certified Case Manager (CCM), or equivalent preferred. Additional Information Advantages of this Opportunity: Hours for this ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Quick apply
RN Case Manager Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care ...
Demonstrates compliance with facility-wide Utilization Management policies and procedures ... Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care ...
Rn Utilization Management information
See salary details
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
How much do rn utilization management jobs pay per year?
As of Aug 23, 2026, the average yearly pay for rn utilization management in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.
What are popular job titles related to Rn Utilization Management jobs?
For Rn Utilization Management jobs, the most frequently searched job titles are:
What job categories do people searching Rn Utilization Management jobs look for?
The top searched job categories for Rn Utilization Management jobs are:
What cities are hiring for Rn Utilization Management jobs?
Cities with the most Rn Utilization Management job openings:
What states have the most Rn Utilization Management jobs?
States with the most job openings for Rn Utilization Management jobs include:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 5 days ago
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
570th of 893 rated healthcare providers
Job description
Employment Type:
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
Minimum Qualifications:
Position Highlights and Benefits:
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
Full timeShift:
Day Shift
Description:
Why MediGold?
MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more.
Position Purpose:
Director Utilization Review directs the department's activities and resources to ensure alignment with the mission, values, and objectives of the department and organization
What you will do:
- Develops and implements departmental strategic goals, plans, and standards consistent with the clinical, administrative, legal, and ethical requirements/objectives of the organization. Oversees compliance with regulations, laws and ethics via audits and direct observation. Provides leadership in developing and implementing standardized tools, roles and systems to support Utilization Review
- Directs and evaluates departmental operations. Leads operational improvements to facilitate standardization of utilization review practices. Establishes metrics to achieve service targets. Oversees and evaluates programs and services focused on continuous quality improvement. Participates in review of contracts and agreement of services
- Plans and monitors staffing activities, including hiring, orienting, evaluating, disciplinary and continuing education initiatives. Develops network of high performing teams
- Prepares, monitors, and evaluates departmental budgets, and ensures that the department operates within the allocated funding
- Participates as an active management member of the Mount Carmel Health Plan representing the Utilization Review Department in collaboratively meeting operational, budget, and strategic planning goals
Minimum Qualifications:
- Education: Bachelor of Science Degree in Nursing, Business or other Healthcare related field. Master's Degree preferred
- Licensure/ Certification: RN License through the State of Ohio
- Experience: 10+ years experience in clinical nursing and utilization management with at least 3+ years of utilization management experience at a Managed Care organization.
- Working knowledge of utilization review practices related to regulatory and accreditation requirements.
- Proven team leader with the ability to interact with all levels of staff members and physicians and other healthcare providers.
- Ability to prioritize issues and solve complex problems.
- Proficient computer, written and verbal communication skills including presentation skills.
- Innovative and self-directed.
- Demonstrates a high tolerance for ambiguity and change and provides leadership to department colleagues and others to adapt effectively to meet changing environment.
Position Highlights and Benefits:
- Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.
- Retirement savings account with employer match starting on day one.
- Generous paid time off programs.
- Employee recognition programs.
- Tuition/professional development reimbursement starting on day one.
- RN to BSN tuition 100% paid at Mount Carmel's College of Nursing.
- Relocation assistance (geographic and position restrictions apply).
- Employee Referral Rewards program.
- Mount Carmel offers DailyPay - if you're hired as an eligible colleague, you'll be able to see how much you've made every day and transfer your money any time before payday. You deserve to get paid every day!
- Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.
Ministry/Facility Information:
Mount Carmel, a member of Trinity Health, has been a transforming healing presence in Central Ohio for over 135 years. Mount Carmel serves over 1.3 million patients each year at our five hospitals, free-standing emergency centers, outpatient facilities, surgery centers, urgent care centers, primary care and specialty care physician offices, community outreach sites and homes across the region. Mount Carmel College of Nursing offers one of Ohio's largest undergraduate, graduate, and doctor of nursing programs. If you're seeking a rewarding career where your purpose, passion, and desire to make a difference come alive, we invite you to consider joining our team. Here, care is provided by all of us For All of You!
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.
What Trinity Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Trinity Health
Sourced by ZipRecruiter
Trinity Health Ann Arbor is a 537 -bed teaching hospital located on 340 acre campus. Recognized by IBM Watson as a Top 100 Hospital and #1 Teaching Hospital, Trinity Health Ann Arbor has been a leading health care provider for more than 100 years. Trinity Health has received numerous local and national awards in recognition of our leadership, quality outcomes, and clinical excellence.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Livonia, MI, US