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Entry Level Utilization Review Nurse Jobs in Indiana

Riverview Health

Clinical Case Mgr

Noblesville, IN · On-site

Five (5) years' experience in utilization review and discharge planning. License/Certification Requirements * Minimim: Registered Nurse, Licensed Social Worker, Clinical Social Worker, or LMSW as ...

ScionHealth

Case Manager II PRN

Indianapolis, IN · On-site

... utilization of resources, service delivery and compliance with external review agencies. Provides ... Graduate of an accredited program required for RN. BSN preferred; or MSW/BSW with licensure as ...

UHS

UR Coordinator (PRN)

Kouts, IN · On-site

Experience in patient assessment, family motiviation, treatment planning and communication with external review organizations or comparable entities. • RN, LSW, LCSW license or equivalent. EEO ...

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All JobsUtilization Review Nurse JobsEntry Level Utilization Review Nurse JobsEntry Level Utilization Review Nurse Jobs in Indiana

Entry Level Utilization Review Nurse information

See Indiana salary details

$20

$40

$65

How much do entry level utilization review nurse jobs pay per hour?

As of Aug 9, 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.

How to get into utilization review as an entry level utilization review nurse?

To become an entry-level utilization review nurse, candidates typically need a nursing license (RN) and relevant clinical experience. Gaining knowledge of insurance policies, medical coding, and utilization review processes through training or certification programs such as the Certified Professional in Healthcare Quality (CPHQ) can improve job prospects.

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?

AspectEntry Level Utilization Review NurseUtilization Review Nurse
CredentialsRN license, possibly some certificationRN license, often with additional certifications
Work EnvironmentHospitals, insurance companies, healthcare facilitiesInsurance companies, healthcare organizations
Job ResponsibilitiesAssist in reviewing patient cases, gather data, support senior staffEvaluate 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.

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.

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.
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:
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:
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:
Entry Level Utilization Review Nurse jobs near you
Infographic showing various Entry Level Utilization Review Nurse job openings in Indiana as of August 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $83,687 per year, or $40.2 per hour.

Clinical Case Mgr

Riverview Health

Noblesville, IN • On-site

Full-time

Posted 11 days ago

Riverview Health rating

6.1

Company rating: 6.1 out of 10

Based on 26 frontline employees who took The Breakroom Quiz

846th of 1,055 rated hospitals

Job description

Job Summary
The Case Manager is responsible for coordinating all aspects of patient's hospitalization via activities related to the patients' clinical course of treatment, resource management, quality improvement and medical discharge planning. Performs utilization reviews, review medical records and coordinates with various payers to ensure payment and appropriate reimbursement.
Job Responsibilities
  • Analyze patient records and assume responsibility and accountability for admission and concurrent reviews assuring the prevention of denials from all payers. Assist with notification, submitting clinical information, and coordinates with payors for approval of services within timeframes indicated by each payor.
  • Compare hospital medical records to established care guidelines and communicates with various members of the multidisciplinary treatment team re expected length of stay, variances, readiness for discharge or transfer to the next appropriate level of care, and optimal recovery course/benchmarks.
  • Support utilization review in monitoring, reporting and documenting on appeals at all levels, peer to peer reviews and reconsideration, and utilization review metrics.
  • Communicate with attending and ED physician regarding bed status and level of care criteria. Refer questionable cases to a Physician Advisor for review, following up with attending as indicated.
  • Coordinate delivery of regulatory documents and may communicate with a discharge planner as needed regarding any changes in bed status.
  • Research clinical records, appropriate insurance and governmental regulations, accrediting agency standards, and history of the claim to determine next step.
  • Ensure collaborative planning processes are maximized and informed decisions are made from a person-centered, strengths-based approach; in conjunction with the patient, family and healthcare team, assess and evaluate medical, rehabilitative, psychosocial and physical needs of observation and inpatient admission to ensure appropriate discharge plan are implemented.
  • Reassess and reevaluate the appropriateness for the plan of care, evaluate progress towards goals, and ensure that the plan is implemented in a timely fashion. Informs team members of current patient status and post discharge care planning process.
  • Review plan of care and expectations with the patient, family, physician, and healthcare team members. Assist patients in problem solving potential challenges related to the health care system, financial or social barriers.
  • Discuss all aspects of care planning with sensitivity and cultural awareness.
  • Coordinate with all agencies involved in the patient's pre-hospital care as well as those planning for post hospital care, including but not limited to: home health, skilled facilities, LTACH's, and DME companies.
  • Provide necessary data to make a referral, provide pertinent information to facilitate transitions of care, schedule post discharge PCP appointments, and follow up with high risk patients post discharge to ensure plan occurred as expected, intervening when required.
  • Serve as a contact, advocate, and informational resource for patient and their family. Acts as a patient and or family advocate by assisting the patient in achieving autonomy and self determination to reach their goals. This includes education on advance directives, patient rights and responsibilities, and regulatory notices, such as the IMM and MOON.
  • Help patients express their views and choices by eliciting preferences and priorities from the patient and family regarding the discharge.
  • Other duties as assigned.

Education Requirements
  • Minimum: Associate Degree in Nursing (ASN) or BA/BS in Social Work
  • Preferred: BSN or MSW in Social Work

Experience Requirements
  • Minimum: Two (2) years' experience in utilization review and discharge planning. Both required
  • Preferred: Five (5) years' experience in utilization review and discharge planning.

License/Certification Requirements
  • Minimim: Registered Nurse, Licensed Social Worker, Clinical Social Worker, or LMSW as appropriate based on educational preparation.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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