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Utilization Review Rn Jobs in Columbus, OH (NOW HIRING)

LMHS

RN Case Manager - Case Management

Newark, OH · On-site

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 ...

LMHS

RN Case Manager - Case Management

Newark, OH

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 ...

LMHS

RN Case Manager - Case Management

Newark, OH · On-site

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 ...

Ohio Hospital for Psychiatry

Registered Nurse

Columbus, OH · On-site

$36 - $40/hr

Demonstrate knowledge and utilization of universal precautions in providing direct patient care ... Must possess a current Registered Nurse (RN) license as required by Ohio or be eligible to practice ...

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Utilization Review Rn information

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$39

$64

How much do utilization review rn jobs pay per hour?

As of Jun 1, 2026, the average hourly pay for utilization review rn in Columbus, OH is $39.51, according to ZipRecruiter salary data. Most workers in this role earn between $31.20 and $45.38 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Utilization Review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

How does a Utilization Review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What is a Utilization Review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

What are the most commonly searched types of Utilization Review Rn jobs in Columbus, OH? The most popular types of Utilization Review Rn jobs in Columbus, OH are:
What are popular job titles related to Utilization Review Rn jobs in Columbus, OH? For Utilization Review Rn jobs in Columbus, OH, the most frequently searched job titles are:
What job categories do people searching Utilization Review Rn jobs in Columbus, OH look for? The top searched job categories for Utilization Review Rn jobs in Columbus, OH are:
What cities near Columbus, OH are hiring for Utilization Review Rn jobs? Cities near Columbus, OH with the most Utilization Review Rn job openings:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Columbus, OH as of May 2026, with employment types broken down into 100% Full Time. Highlights an 67% In-person, and 33% Remote job distribution, with an average salary of $82,172 per year, or $39.5 per hour.

Case Manager (RN / RT / SW) Sign On Bonus

Select Specialty Hospital - Columbus Vic Village(Grant)

Columbus, OH • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

Job description

Overview
Select Specialty Hospital
Critical Illness Recovery Hospital (LTACH)
$10,000 Sign On Bonus
Case Manager
Full Time: Monday-Friday 8-5pm
Requires a current licensure in a clinical discipline either as a Nurse (RN/LPN/LVN) or a Respiratory Therapist (RT) OR Medical Social Work (license per state guidelines).
And
Previous discharge planning experience preferred.
Our hospital is a critical illness recovery hospital committed to providing world-class inpatient post-ICU services to chronic, critically ill patients who require extended healing and recovery. We help patients during some of the most vulnerable, painful moments of their lives - and our team plays a central role in providing compassionate, excellent care every step of the way.
Responsibilities
We are looking for valued employees who will be Champions of the Select Medical Way, which includes putting the patient first, helping to improve quality of life for the community in which you live and work, continuing to develop and explore new ideas, providing high-quality care and doing well by doing what is right.
The Case Manager is responsible for utilization reviews and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation. You will report directly to the Director of Case Management and provide social work services, as necessary, per state guidelines.
  • Develops and implements a patient specific, safe and timely discharge plan.
  • Performs verification of utilization criteria reviews.
  • Builds relationships and coordinate with payor sources to assure proper reimbursement for hospital provided services, promote costs attentive care via focus on resource management within the plan of care.
  • Demonstrates compliance with facility-wide Utilization Management policies and procedures.
  • Coordinates UR compliance with Quality Management to assure all licensure and accrediting requirements are fulfilled.
  • Maintains fiscal responsibilities. Assures the department is identifying and negotiating the fullest possible reimbursement to maximize insurance benefit coverage for the patient. Reviews insurance verification forms to minimize risk.
  • Facilitates multi-disciplinary team meetings including physicians, nurses, respiratory therapists and rehabilitation therapists.

Qualifications
We are seeking results-driven team players. Qualified candidates must be passionate about providing superior quality in all that they do.
Minimum requirements:
  • Current licensure in a clinical discipline either as a Nurse or a Respiratory Therapist (RN preferred) OR current license / certified Social Work license per state guidelines
  • Previous RN/LPN/RT/SW/CM experience in an inpatient hospital setting dealing with critical care/acute care patients. (example: ICU, step-down, med surg, vents)

Preferred qualifications that will make you successful:
  • Specific experience in Care Management and Discharge Planning is preferred.
  • Working knowledge of the insurance industry and government reimbursement.

Additional Data
General Benefits Full-time
  • Start Strong: Extensive and thorough orientation program to ensure a smooth transition into our setting
  • Recharge & Refresh: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance
  • Your Health Matters: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members
  • Invest in Your Future:Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members
  • Your Impact Matters:Join a team of over 44,000 committed to providing exceptional patient care

Equal opportunity employer, including disabled veterans

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