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Insurance Utilization Review Jobs in Indiana (NOW HIRING)

ScionHealth

Case Manager II PRN

Indianapolis, IN · On-site

... utilization of resources, service delivery and compliance with external review agencies. Provides ... Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ...

Seven Healthcare

RN - Case Management

Fort Wayne, IN · On-site

$2.7K/wk

Health insurance - comprehensive medical coverage for you and your family * Certification ... Utilization Review: Collaborate with the Care Team * Complete comprehensive patient assessments to ...

New

Mulhaupts

Scheduling Coordinator

Lafayette, IN · On-site

$17 - $19/hr

... utilization. * Review work orders daily; ensure all necessary details are captured before ... Health, dental, vision insurance. * PTO / Paid holidays. * 401(k) / Retirement benefits.

Mulhaupt's

Scheduling Coordinator

Lafayette, IN · On-site

$17 - $21.75/hr

... utilization. * Review work orders daily; ensure all necessary details are captured before ... Health, dental, vision insurance. * PTO / Paid holidays. * 401(k) / Retirement benefits.

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Insurance Utilization Review information

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How much do insurance utilization review jobs pay per hour?

As of Jun 30, 2026, the average hourly pay for insurance utilization review 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 the most common challenges faced by Insurance Utilization Review professionals?

One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.

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

To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.

What is an Insurance Utilization Review job?

An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

What are the most commonly searched types of Insurance Utilization Review jobs in Indiana? The most popular types of Insurance Utilization Review jobs in Indiana are:
What are popular job titles related to Insurance Utilization Review jobs in Indiana? For Insurance Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Insurance Utilization Review jobs in Indiana look for? The top searched job categories for Insurance Utilization Review jobs in Indiana are:
What cities in Indiana are hiring for Insurance Utilization Review jobs? Cities in Indiana with the most Insurance Utilization Review job openings:
Insurance Utilization Review jobs near you
Case Manager II PRN

Case Manager II PRN

ScionHealth

Indianapolis, IN • On-site

Per diem

Posted 26 days ago

Key responsibilities

  • Coordinates and facilitates patient care through collaboration and communication with the interdisciplinary care team.

  • Provides ongoing support through comprehensive assessment, care planning, implementation, and evaluation of individual patient needs.

  • Participates in patient care rounds or conferences to review treatment goals, optimize resource utilization, and plan for post-hospital needs.

ScionHealth rating

6.0

Company rating: 6.0 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

731st of 877 rated healthcare providers

Job description

Kindred Hospital Indianapolis North is a 45-bed long-term acute care hospital offering the same in depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. We are located within American National University community.
Job Summary
Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
Essential Functions
Care Coordination
  • Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
  • Monitors all areas of patients' stay for effective care coordination and efficient care facilitation.
  • Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
  • Appropriately refers high risk patients who would benefit from additional support.
  • Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient's and family's ability to make informed decisions.
  • Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served.
  • Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post hospital needs. Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.
  • Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients' care throughout the care continuum.

Knowledge/Skills/Abilities/Expectations
  • Knowledge of government and non-government payor practices, regulations, standards and reimbursement.
  • Knowledge of Medicare benefits and insurance processes and contracts.
  • Knowledge of accreditation standards and compliance requirements.
  • Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
  • Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheet software.
  • Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers
  • Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members.
  • Approximate percent of time required to travel: 0%
  • Must read, write and speak fluent English.
  • Must have good and regular attendance.
  • Performs other related duties as assigned.

Qualifications
Education
  • Graduate of an accredited program required for RN. BSN preferred; or MSW/BSW with licensure as required by state regulations

Licenses/Certification
  • Healthcare professional licensure required as Registered Nurse, or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.
  • Certification in Case Management a plus.

Experience
  • Two years of experience in a healthcare setting preferred.
  • Prefer prior experience in case management, utilization review, or discharge planning.

What ScionHealth employees say

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