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Director Utilization Management Jobs in Indiana (NOW HIRING)

HHC

UTILIZATION REVIEW SPECIALIST

Indianapolis, IN

Ability to provide direct support to providers regarding utilization, authorization, and referral activities Knowledge of office procedures and Utilization Management Policies Team player, verbal and ...

MISO

Manager Resource Utilization

Carmel, IN · On-site

$166K - $191K/yr

As MISO's Manager - Resource Utilization, you will lead a team at the center of critical ... Direct the development, validation, and maintenance of power flow, short circuit, stability, and ...

219 Health Network

U.M. Tech

Hobart, IN · On-site

Utilization Management Technician Assigns admission codes for DRG assignment, coordinates Utilization Management Committee physician advisor review activities, assists the Director with preparation ...

New

Powers Health

U.M. Tech

Hobart, IN · On-site

Assigns admission codes for DRG assignment, coordinates Utilization Management Committee physician advisor review activities, assists the Director with preparation for the Utilization Management ...

Powers Health

U.M. Tech

Hobart, IN · On-site

$18.95 - $30.92/hr

Assigns admission codes for DRG assignment, coordinates Utilization Management Committee physician advisor review activities, assists the Director with preparation for the Utilization Management ...

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Director Utilization Management information

See Indiana salary details

$17.1K

$49.8K

$79.9K

How much do director utilization management jobs pay per year?

As of Jun 9, 2026, the average yearly pay for director utilization management in Indiana is $49,787.00, according to ZipRecruiter salary data. Most workers in this role earn between $38,100.00 and $57,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the Director Utilization Management position, and why are they important?

To thrive as a Director Utilization Management, you need a strong background in healthcare administration, case management, and data-driven decision-making, often supported by a clinical degree and several years of management experience. Familiarity with utilization management software, electronic health records (EHRs), and certifications such as CCM or ACM are typically valued. Exceptional leadership, communication, and problem-solving skills distinguish top performers in this role. These competencies are vital for optimizing resource use, ensuring regulatory compliance, and leading teams to meet quality care standards.

What is a Director Utilization Management job?

A Director of Utilization Management oversees the review and approval of medical services to ensure they are necessary, efficient, and cost-effective. They develop strategies to improve care quality while managing healthcare costs, working closely with providers, payers, and regulatory bodies. Their responsibilities include policy development, compliance with healthcare regulations, and leading a team of utilization review professionals. This role is common in hospitals, insurance companies, and managed care organizations.

What are the typical daily responsibilities of a Director Utilization Management?

A Director Utilization Management generally oversees a team responsible for reviewing patient care to ensure appropriate resource use and compliance with payer requirements. Daily tasks may include analyzing utilization data, developing policy and process improvements, collaborating with clinical and administrative staff, and addressing escalated cases or issues. Directors frequently attend strategy meetings, conduct staff training, and engage with external partners like insurance providers. This role requires balancing administrative oversight with hands-on problem solving to support both cost efficiency and quality patient care.

What are the most commonly searched types of Utilization Management jobs in Indiana? The most popular types of Utilization Management jobs in Indiana are:
What are popular job titles related to Director Utilization Management jobs in Indiana? For Director Utilization Management jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Director Utilization Management jobs in Indiana look for? The top searched job categories for Director Utilization Management jobs in Indiana are:
What cities in Indiana are hiring for Director Utilization Management jobs? Cities in Indiana with the most Director Utilization Management job openings:
Director Utilization Management jobs near you
Infographic showing various Director Utilization Management job openings in Indiana as of May 2026, with employment types broken down into 97% Full Time, and 3% Part Time. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $49,787 per year, or $23.9 per hour.

Utilization Management Nurse

SIHO HOLDING INC

Columbus, IN

Other

Posted 13 days ago

Job description

Job Title:  Utilization Management Nurse
Reports To:  Manager of Utilization Management
Employment Type:  Full-Time, Exempt

Brief Description of Duties:    
This position is reserved for a licensed Registered Nurse who will perform the Utilization Management (UM) services for SIHO (and affiliated business lines’) members. This individual’s primary role is to ensure that health care services are administered with quality, cost effectiveness, and compliance to plan guidelines. By performing review of services prospectively, retrospectively, and throughout the episode of care, the UM nurse will make coverage determinations influencing how services are allocated to SIHO’s various member populations.  A candidate’s ability to perform quality reviews within strict efficiency standards is required for this position.  Key responsibilities are as follows:

  • Pre-service, concurrent, and post-service review for medical necessity of health care services utilizing enrollee medical records and established guidelines set by SIHO and/or state and federal (CMS) guidelines
  • Interaction with the member, health care provider, and/or other care team members to complete reviews in most time-efficient manner
  • Interaction with the SIHO Medical Director or external Medical Reviewers as needed to ensure proper medical necessity decisions are made in a timely manner
  • Appropriate documentation of the entire review process utilizing the established documentation system and desk procedures to guarantee accurate reporting metrics and data integrity
  • Complete case review and manage turnaround times to assure determinations are rendered within the contractual and regulatory turnaround times established by SIHO and CMS
  • Assist in problem resolution and provide guidance to members of the team and cohorts
  • Interpret and abide by organizational policies and procedures; review work regularly to ensure that policies and guidelines are appropriately applied
  • Act as a clinical resource to the department and other organization members for services pertaining to medical management, utilization review, and medical necessity 
  • Act and perform within the scope of professional nursing practice; display responsibility in supporting and participating in department strategies and efforts focused on quality improvement
  • Responsible for the early identification and assessment of members for inclusion in disease management or care management programs
  • Assist in the identification and reporting of Potential Quality of Care concerns and Fraud, Waste and Abuse incidents
  • Work as an interdisciplinary team member within Medical Management for all lines of business and commercial group plans
  • Show effective prioritization, efficiency and accuracy of work product in alignment with department goals.

Minimum Skills Requirement:

  • Registered Nurse with current, unrestricted license in primary state of employment (position may require additional licensing in other states as necessary)
  • Previous UM or Health Plan experience highly preferred
  • Desire to work in a fast-paced environment with focus on efficiency and attention to detail while maintaining quality
  • Self-directed organizational and prioritization skills, and independent time management skills required
  • Sound clinical background with experience in the clinical field
  • Excellent verbal and written communication skills
  • Microsoft Office Experience: Outlook, Word, Excel

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