Conducts utilization reviews of behavioral health cases to determine medical necessity ... management to maintain appropriate and cost-effective patient care. * Documents all case reviews ...
Conducts utilization reviews of behavioral health cases to determine medical necessity ... management to maintain appropriate and cost-effective patient care. * Documents all case reviews ...
UR Coordinator, Full Time
$24 - $32/hr
Experience in utilization review, case management, medical records, or healthcare billing strongly preferred * Strong understanding of insurance authorization processes (Medicare, Medicaid, and ...
UR Coordinator, Full Time
$24 - $32/hr
Experience in utilization review, case management, medical records, or healthcare billing strongly preferred * Strong understanding of insurance authorization processes (Medicare, Medicaid, and ...
Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok ...
No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
Quick apply
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
Quick apply
RN Case Manager
Columbus, OH · On-site
Work closely with Utilization Review team in coordinating C-9 (treatment plan)/vocational rehab ... Case Management Team Lead * Assess documentation of medical records for completeness on a ...
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
The position's objective is to provide high quality customer service in workers' compensation medical case management and utilization review, primarily telephonically.The Nurse Case Manager provides ...
New
Nurse Case Manager
Columbus, OH · On-site
$55K - $110K/yr
The position's objective is to provide high quality customer service in workers' compensation medical case management and utilization review, primarily telephonically.The Nurse Case Manager provides ...
New
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Quick apply
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
RN Case Manager Position Summary The case manager is responsible for individualized management of ... Utilization review and or discharge planning experience preferred * Excellent verbal and written ...
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
Quick apply
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
Serve as the primary clinical administrator for Case Management/ Utilization Review applications such as: * MCG- Milliman Care Guidelines * R1- Physician Advisor * Payer Portal Administrator
Case Manager
Westerville, OH · On-site
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications • License or ...
Case Manager
Westerville, OH · On-site
$19.50 - $25/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications • License or ...
Case Manager
$19.25 - $24.75/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
Case Manager
$19.25 - $24.75/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications License or Certification:
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 ...
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 ...
Utilization Review Case Manager information
See salary details
$16.59 - $20.54
3% of jobs
$20.54 - $24.50
1% of jobs
$24.50 - $28.45
6% of jobs
$30.36 is the 25th percentile. Wages below this are outliers.
$28.45 - $32.41
30% of jobs
The median wage is $33.83 / hr.
$32.41 - $36.36
26% of jobs
$37.87 is the 75th percentile. Wages above this are outliers.
$36.36 - $40.32
22% of jobs
$40.32 - $44.27
3% of jobs
$44.27 - $48.23
0% of jobs
$48.23 - $52.19
5% of jobs
$52.19 - $56.14
2% of jobs
$56.14 - $60.10
1% of jobs
$16
$36
$60
How much do utilization review case manager jobs pay per hour?
As of Aug 21, 2026, the average hourly pay for utilization review case manager in the United States is $36.49, according to ZipRecruiter salary data. Most workers in this role earn between $29.57 and $38.46 per hour, depending on experience, location, and employer.
What are popular job titles related to Utilization Review Case Manager jobs?
For Utilization Review Case Manager jobs, the most frequently searched job titles are:
- Evening Optum Health Utilization Review
- Home Based Utilization Review Nurse
- Weekend Physician Advisor Utilization Review
- Evening Utilization Review Nurse
- Per Diem Utilization Review Nurse
- No Experience Utilization Management Nurse
- Full Time Physician Advisor Utilization Review
- Temporary Utilization Review Nurse
- Non Exempt No Experience Utilization Management Nurse
- Freelance Utilization Review Nurse
What job categories do people searching Utilization Review Case Manager jobs look for?
The top searched job categories for Utilization Review Case Manager jobs are:
- Concurrent Review
- Registered Nurse Case Review
- International Utilization Review Rn
- Senior Rn Utilization Review Nurse
- Temporary Aetna Utilization Review Nurse
- Utilization Review No Experience
- Utilization Management Review Nurse
- Rn Utilization Review Nurse
- Cigna Utilization Review Nurse
- Lpn Utilization Review
What cities are hiring for Utilization Review Case Manager jobs?
Cities with the most Utilization Review Case Manager job openings:
What states have the most Utilization Review Case Manager jobs?
States with the most job openings for Utilization Review Case Manager jobs include:
Full-time
Re-posted yesterday
Nationwide Children's Hospital rating
6.9
Based on 131 frontline employees who took The Breakroom Quiz
550th of 1,061 rated hospitals
Job description
Overview:
Schedule: Monday-Friday (8:00am-4:30pm)
Position is work from home after a 90 day in-office training period.
Job Description Summary:
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.
Job Description:
Essential Functions:
Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, required.
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
Experience:
Physical Requirements:
OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel
FREQUENTLY: Standing, Walking
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
(not specified)
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
Schedule: Monday-Friday (8:00am-4:30pm)
Position is work from home after a 90 day in-office training period.
Job Description Summary:
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.
Job Description:
Essential Functions:
- Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines.
- Communicates with healthcare teams and third-party payors to ensure the delivery of quality care and optimum payment.
- Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
- Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
- Provides education and support regarding utilization review and management activities and processes.
- Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
- Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.
Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, required.
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
- Excellent written and verbal communication and interpersonal skills.
- Excellent customer service and organizational skills.
- Working knowledge of CMS and other review agency standards.
- Proficient with software applications including CM, payer web applications, MITS, and others.
Experience:
- Three years of behavioral health experience, required.
- One year of experience in pediatric care or services, required.
- Utilization review or utilization management experience, preferred.
Physical Requirements:
OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel
FREQUENTLY: Standing, Walking
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
(not specified)
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
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About Nationwide Children's Hospital
Sourced by ZipRecruiter
Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Columbus, OH, US
Year founded
1892