Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning * Review admissions and ongoing patient cases; recommend or ...
... reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Qualifications * Must have clear and active RN license in the state of IN * AS ...
... reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Qualifications * Must have clear and active RN license in the state of IN * AS ...
Utilization Review RN
$30 - $34/hr
Expected to review 20 cases a day with a 95% accuracy rate. Responsible for collaborating with ... Must have clear and active RN license in the state of IN * 2 years of experience in a acute care ...
Utilization Review RN
$30 - $34/hr
Expected to review 20 cases a day with a 95% accuracy rate. Responsible for collaborating with ... Must have clear and active RN license in the state of IN * 2 years of experience in a acute care ...
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
New
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
New
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
New
... Utilization Review Coordinator to coordinate patients' services across the continuum of care by ... Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
New
The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... Graduation from an approved/accredited school of nursing or a Bachelor's degree in social work ...
The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays ... Graduation from an approved/accredited school of nursing or a Bachelor's degree in social work ...
Utilization Management Nurse
Columbus, IN · On-site
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Quick apply
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Be Seen First
Utilization Management Nurse
Columbus, IN · On-site
Job Title: Utilization Management Nurse Reports To: Manager of Utilization Management Brief ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Quick apply
Be Seen First
Utilization Management Nurse
Columbus, IN · On-site
Job Title: Utilization Management Nurse Reports To: Manager of Utilization Management Brief ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Rep I Utilization Management RepresentativeI Location: Virtual: This role ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I Utilization Management RepresentativeI Location: Virtual: This role ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management RepresentativeI Location: Virtual: This role enables associates to work ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management RepresentativeI Location: Virtual: This role enables associates to work ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
RN Care Manager
Evansville, IN · On-site
$85K - $95K/yr
Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS, prevent readmissions, improve outcomes ✅ What You Bring: * Active RN license (Indiana or compact)
Quick apply
RN Care Manager
Evansville, IN · On-site
$85K - $95K/yr
Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS, prevent readmissions, improve outcomes ✅ What You Bring: * Active RN license (Indiana or compact)
Nurse
Marion, IN · On-site
$68K/yr
The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM ... Credit for foreign nursing education higher that associate degree/entry level requires a formal ...
Nurse
Marion, IN · On-site
$68K/yr
The Revenue Utilization Review (RUR) nurse is under the supervision of the Nurse Manager and ANM ... Credit for foreign nursing education higher that associate degree/entry level requires a formal ...
Follows nursing policies and procedures per agency standards. * Demonstrates a thorough ... Participates in quality improvement and utilization review activities. * Participates in the ...
Follows nursing policies and procedures per agency standards. * Demonstrates a thorough ... Participates in quality improvement and utilization review activities. * Participates in the ...
Follows nursing policies and procedures per agency standards. * Demonstrates a thorough ... Participates in quality improvement and utilization review activities. * Participates in the ...
Follows nursing policies and procedures per agency standards. * Demonstrates a thorough ... Participates in quality improvement and utilization review activities. * Participates in the ...
Entry Level Utilization Review Nurse information
See Indiana salary details
$20.36 - $24.48
2% of jobs
$24.48 - $28.59
9% of jobs
$31.41 is the 25th percentile. Wages below this are outliers.
$28.59 - $32.71
21% of jobs
The median wage is $36.04 / hr.
$32.71 - $36.83
23% of jobs
$36.83 - $40.94
13% of jobs
$44.15 is the 75th percentile. Wages above this are outliers.
$40.94 - $45.06
10% of jobs
$45.06 - $49.18
8% of jobs
$49.18 - $53.30
5% of jobs
$53.30 - $57.41
5% of jobs
$57.41 - $61.53
2% of jobs
$61.53 - $65.65
2% of jobs
$20
$40
$65
How much do entry level utilization review nurse jobs pay per hour?
As of Jul 30, 2026, the average hourly pay for entry level utilization review nurse in Indiana is $40.23, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.20 per hour, depending on experience, location, and employer.
What are some common challenges faced by entry level Utilization Review Nurses, and how can they overcome them?
Entry level Utilization Review Nurses often encounter challenges such as adapting to complex insurance policies, learning to review medical records efficiently, and communicating effectively with physicians and case managers. To overcome these challenges, new nurses should seek mentorship from experienced colleagues, participate in ongoing training sessions, and familiarize themselves with the organization's review protocols and documentation systems. Building strong communication skills and staying up to date with regulatory changes will also help in navigating the learning curve and ensuring successful case reviews.
What is the difference between Entry Level Utilization Review Nurse vs Utilization Review Nurse?
| Aspect | Entry Level Utilization Review Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, possibly some certification | RN license, often with additional certifications |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Insurance companies, healthcare organizations |
| Job Responsibilities | Assist in reviewing patient cases, gather data, support senior staff | Evaluate medical necessity, review patient records, make coverage decisions |
The Entry Level Utilization Review Nurse typically supports the more experienced Utilization Review Nurse by gathering information and assisting in case reviews. Both roles require an RN license and work within healthcare or insurance settings, but the entry-level position involves more support tasks, while the Utilization Review Nurse makes critical coverage decisions.
How to make $300,000 as a nurse?
An entry level utilization review nurse can increase earning potential by gaining specialized certifications, such as Certified Case Manager (CCM), and accumulating experience in high-demand settings. Advancing to senior or managerial roles, working overtime, or obtaining additional qualifications can also help reach higher salary levels, though earning $300,000 typically requires significant experience and specialization beyond entry level.
How to get into utilization review as a nurse?
To become an entry-level utilization review nurse, candidates typically need a registered nurse (RN) license and relevant clinical experience. Gaining knowledge of insurance processes, medical coding, and utilization review guidelines, along with completing any required certifications such as Certified Professional in Healthcare Quality (CPHQ), can improve job prospects.
What are the key skills and qualifications needed to thrive as an Entry Level Utilization Review Nurse, and why are they important?
To thrive as an Entry Level Utilization Review Nurse, you need a registered nurse (RN) license, knowledge of clinical guidelines, and an understanding of healthcare regulations. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are often beneficial. Strong analytical thinking, attention to detail, and effective communication skills help you review cases accurately and collaborate with providers. These skills ensure appropriate care decisions, compliance with payer requirements, and optimal patient outcomes.
Is it hard to be a utilization review nurse?
Being an entry-level utilization review nurse involves reviewing medical records and determining coverage eligibility, which requires attention to detail, strong communication skills, and knowledge of healthcare policies. The role can be demanding due to the need for accuracy and adherence to regulations, but it often offers a structured environment with standard work hours. Certification in case management or utilization review can enhance job prospects and effectiveness.
What is an Entry Level Utilization Review Nurse?
An Entry Level Utilization Review Nurse is a registered nurse (RN) who is new to the field of utilization review. Their main responsibilities include assessing medical records, ensuring that patients receive appropriate and necessary care, and verifying that health services are delivered according to established guidelines and insurance requirements. They typically work for hospitals, insurance companies, or managed care organizations and collaborate with healthcare providers to support quality patient outcomes while managing costs. This role often serves as a stepping stone to more advanced positions in healthcare administration or case management.
How to make an extra 2000 a month as a nurse?
An entry level utilization review nurse can increase income by taking on additional part-time or freelance review assignments, obtaining relevant certifications like the Certified Professional Coder (CPC), or working overtime if available. Developing specialized skills in medical coding, documentation, or telehealth can also open opportunities for higher-paying side work or contract roles.
What are the most commonly searched types of Utilization Review Nurse jobs in Indiana? The most popular types of Utilization Review Nurse jobs in Indiana are:
What are popular job titles related to Entry Level Utilization Review Nurse jobs in Indiana? For Entry Level Utilization Review Nurse jobs in Indiana, the most frequently searched job titles are:
- No Experience Utilization Review Nurse
- Night Utilization Review Nurse
- Remote Utilization Management Nurse
- Medical Review Nurse
- Weekend Prior Authorization Nurse
- Flex Schedule Remote Utilization Review Nurse
- Registered Nurse Utilization Review
- Remote Utilization Management
- Appeals Nurse
- Remote Chart Review Nurse
What job categories do people searching Entry Level Utilization Review Nurse jobs in Indiana look for? The top searched job categories for Entry Level Utilization Review Nurse jobs in Indiana are:
- Lpn Utilization Review Nurse
- Humana Insurance Rn
- Anthem Utilization Review Nurse
- Rn Anthem
- Flexible Cigna Utilization Review Nurse
- Remote Occupational Therapy Utilization Review
- Optum Utilization Review Nurse
- Director Optum Utilization Review
- Remote Aetna Utilization Review Nurse
- Aetna Utilization Review Nurse
What cities in Indiana are hiring for Entry Level Utilization Review Nurse jobs? Cities in Indiana with the most Entry Level Utilization Review Nurse job openings:
Part-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 11 days ago
Trinity Health rating
6.6
Based on 354 frontline employees who took The Breakroom Quiz
571st of 890 rated healthcare providers
Job description
Employment Type:
Part timeShift:
Rotating Shift
Description:
This is a remote position but will need onsite training in Mishawaka Indiana.
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Why Choose Saint Joseph Health System?
What We Offer
What You Will Need
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.
Part timeShift:
Rotating Shift
Description:
This is a remote position but will need onsite training in Mishawaka Indiana.
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Why Choose Saint Joseph Health System?
- At Saint Joseph Health System, our values guide every decision we make. Even when challenges arise, we remain committed to our mission: caring for every person who needs us. We invest in our people, our technology, and our capabilities so we can continue delivering exceptional, compassionate care to our communities.
What We Offer
- Tuition reimbursement for all full-time and part-time colleagues starting on day one
- Comprehensive benefits beginning day one (Medical, Dental, Vision, PTO, Life Insurance, STD/LTD, and more)
- Retirement savings plan with employer match
- Generous paid time off program plus 7 paid holidays
- No mandatory overtime
- Employee referral incentive program
- Access to state-of-the-art equipment, unlimited CEUs, and a supportive team-focused work environment
- Conduct clinical reviews of patient records to evaluate medical necessity, appropriateness of admission, treatment, and length of stay across all payor types
- Apply standardized criteria, regulatory guidelines, and insurance requirements to support reimbursement and compliance
- Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning
- Review admissions and ongoing patient cases; recommend or escalate cases that do not meet criteria to leadership or the Utilization Review Committee
- Facilitate timely discharges, transfers, and recertifications when level of care is no longer appropriate
- Partner with Medicare, Medicaid, and private insurers to ensure accurate documentation and reimbursement processes
- Respond to denials and authorization changes by reviewing medical records and communicating outcomes to care teams and patients
- Identify trends and utilization concerns; contribute to performance improvement and quality initiatives
- Maintain accurate records, compile reports, and support utilization review program operations
- Provide education to clinical staff on documentation requirements, coverage guidelines, and utilization processes
- Support compliance with all regulatory, accreditation, and organizational standards
- Participate in committee meetings and assist in development of utilization review plans and processes
What You Will Need
- Graduate of an accredited Registered Nurse (RN) program; Bachelor's Degree in Nursing preferred
- Active RN license (state-specific requirement applies)
- Minimum of 2 years of acute care nursing experience
- Prior utilization review, case management, or payer review experience preferred
- Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines
- Solid understanding of clinical care practices, diagnoses, treatment modalities, and hospital operations
- Excellent communication skills with the ability to collaborate effectively across teams
- Strong analytical and critical thinking skills to assess clinical appropriateness and compliance
- Proficiency in computer systems and Microsoft Office applications
- Ability to manage multiple priorities in a fast-paced healthcare environment
- Flexibility to adapt to changing schedules, workflows, and departmental needs
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
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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