1

Chart Utilization Review Jobs in Indiana (NOW HIRING)

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

... or utilization review. Performs nursing functions specific to the specialty practice and as ... Completing periodic chart audits for staff and providers. * Checking with staff during the day and ...

next page

Showing results 1-20

Chart Utilization Review information

What are the key skills and qualifications needed to thrive as a chart utilization review specialist, and why are they important?

To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.

What is chart utilization review?

Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.

What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?

Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.

What is the difference between Chart Utilization Review vs Chart Review Specialist?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing medical records for coding accuracy and completeness

While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.

Infographic showing various Chart Utilization Review job openings in Indiana as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 14% Part Time, and 3% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution.

Regional Director - Clinical Quality

Jobtailor

Indianapolis, IN โ€ข On-site

$110 - $140/hr

Other

Posted 9 days ago


Job description

  • Provide clinical direction, oversight, and support to assigned facilities across the region.
  • Lead clinical teams in the delivery of safe, ethical, evidence-based, and compliant behavioral health services.
  • Develop clear role expectations for Clinical Directors and clinical team members.
  • Provide leadership, coaching, and support to facility Clinical Directors
  • Develop effective meeting structures for clinical leadership, including bi-weekly virtual individual meetings with Clinical Directors and group meetings as needed.
  • Build strong working relationships with facility Clinical Directors, Executive Directors, clinical staff, and corporate leadership.
  • Report clinical trends, risks, barriers, and operational updates to the supervisor.
  • Ensure clinical services are delivered in accordance with local, state, and federal regulations, Joint Commission accreditation standards, company policies, and payer expectations.
  • Support implementation of policies and procedures consistent with ASAM criteria and organizational best practices.
  • Monitor clinical compliance, quality of care, documentation accuracy, treatment planning, discharge planning, and patient engagement.
  • Establish and maintain clinical quality systems to ensure clients receive care consistent with program expectations, clinical standards, and the client handbook.
  • Conduct frequent clinical quality visits to all assigned treatment centers, at least monthly or more often as needed.
  • Support survey preparedness and provide on-site leadership during regulatory or accreditation surveys when needed.
  • Assist with mock surveys, state surveys, Joint Commission surveys, Plans of Correction, and corrective action follow-up.
  • Monitor implementation and completion of Plans of Correction related to clinical services.
  • Ensure timely, complete, and compliant medical record documentation.
  • Develop and monitor clinical reporting tools, including weekly clinical reports for Clinical Directors and chart audit processes for Executive Directors and Regional Directors.
  • Establish, implement, and monitor submission processes for required clinical reports and audits.
  • Identify documentation concerns and escalated repeated or serious performance issues through the appropriate leadership and human resources processes.
  • Support successful clinical operations across assigned facilities.
  • Assist with clinical system implementation during acquisitions, new facility openings, or operational transitions.
  • Review requests for administrative discharge and provide clinical guidance prior to final disposition.
  • Provide pre-admission clinical reviews as needed.
  • Support clinical assessment processes, client sessions, and direct care needs when necessary.
  • Communicate needed changes and assist with implementation of clinical improvement goals.
  • Serve as a resource regarding clinical issues, addiction treatment trends, mental health treatment trends, regulatory expectations, and clinical best practices.
  • Collaborate with operations, quality, compliance, nursing, medical, admissions, utilization review, and human resources teams to improve clinical performance.
  • Provide regular education, onboarding, and orientation to Clinical Directors and clinical staff.
  • Develop and deliver clinical training to support documentation quality, ASAM alignment, therapeutic standards, regulatory compliance, and evidence-based care.
  • Provide in-service education for staff as requested.
  • Work with Service Excellence to develop and implement clinical staff training and professional development initiatives.
  • Assist with recruitment, interviewing, hiring, and onboarding of qualified Clinical Directors, therapists, and other clinical team members.
  • Support professional growth, accountability, and leadership development across the clinical team.
  • Be available to support facility leadership when significant clinical events, regulatory concerns, safety issues, or urgent operational needs occur.
  • Provide clinical consultation and leadership during critical incidents, adverse events, patient safety concerns, and high-risk discharges.
  • Ensure appropriate follow-up, documentation, communication, and corrective action after clinical events.
Requirements
  • Masterโ€™s degree in counseling, social work, marriage and family therapy, psychology, or a related clinical field required.
  • Independent clinical licensure required in at least one service state, such as LCSW, LMHC, LMFT, or equivalent.
  • Minimum of seven years of experience in residential substance use disorder treatment required.
  • Minimum of five years of leadership experience in a behavioral health setting required.
  • Regional or multi-site clinical leadership experience preferred.
  • Working knowledge of state behavioral health and addiction treatment regulations.
  • Knowledge of ASAM criteria, clinical documentation standards, utilization review, and medical necessity requirements.
  • Knowledge of medication-assisted treatment services preferred.
  • Ability to maintain strict client confidentiality and HIPAA compliance.
  • Demonstrated ethics, integrity, professionalism, and strong customer service skills.
  • Strong understanding of best practices in behavioral health, substance use disorder treatment, and co-occurring disorder care.
  • Ability to travel regularly to assigned facilities.
Core Competencies

Demonstrates expertise in clinical leadership, oversight, and compliance within behavioral health services, ensuring adherence to regulations and best practices. Proficient in developing and implementing clinical training, quality systems, and documentation standards to enhance patient care and operational efficiency.

Highest-signal resume keywords
  • Masterโ€™s Degree In Counseling
  • Independent Clinical Licensure
  • Seven Years Of Experience In Substance Use Disorder Treatment
  • Five Years Of Leadership Experience
  • Knowledge Of ASAM Criteria
ATS Optimization Keywords Hard Skills
  • Clinical Oversight
  • Quality Assurance
  • Clinical Documentation Standards
  • Utilization Review
  • Patient Engagement
  • Treatment Planning
  • Regulatory Compliance
  • Clinical Reporting Tools
  • Medication-Assisted Treatment
  • Mock Surveys
Soft Skills
  • Leadership
  • Coaching
  • Communication
  • Relationship Building
  • Customer Service
Certifications & Qualifications
  • LCSW
  • LMHC
  • LMFT
Industry Keywords
  • Behavioral Health
  • Substance Use Disorder
  • Co-Occurring Disorder Care
  • HIPAA Compliance
  • Clinical Best Practices
#J-18808-Ljbffr