... managed care concepts. Must have good verbal and written communication skills. Must have excellent people skills and the ability to solve problems efficiently and effectively. Must have good ...
... managed care concepts. Must have good verbal and written communication skills. Must have excellent people skills and the ability to solve problems efficiently and effectively. Must have good ...
Utilization Management RN
Indianapolis, IN · On-site
$75K - $100K/yr
This role uses clinical knowledge to provide judgment to review medical services with evidence-based criteria, authorize requested services as appropriate. Our Utilization Management RN will be ...
Utilization Management RN
Indianapolis, IN · On-site
$75K - $100K/yr
This role uses clinical knowledge to provide judgment to review medical services with evidence-based criteria, authorize requested services as appropriate. Our Utilization Management RN will be ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ... Unless specified as primarily virtual by the hiring manager, associates are required to work at an ...
Be Seen First
Utilization Management Nurse
Columbus, IN · On-site
Manager of Utilization Management Brief Description of Duties: This position is reserved for a ... 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
Manager of Utilization Management Brief Description of Duties: This position is reserved for a ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Nurse
Columbus, IN · On-site
Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Quick apply
Utilization Management Nurse
Columbus, IN · On-site
Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Registered Nurse - Utilization Management (Acute Rehab Unit) Ball Memorial Hospital | Muncie ... Conduct utilization review activities for inpatient admissions, outpatient procedures, and ...
Registered Nurse - Utilization Management (Acute Rehab Unit) Ball Memorial Hospital | Muncie ... Conduct utilization review activities for inpatient admissions, outpatient procedures, and ...
Registered Nurse - Utilization Management (Acute Rehab Unit) Ball Memorial Hospital | Muncie ... Conduct utilization review activities for inpatient admissions, outpatient procedures, and ...
Registered Nurse - Utilization Management (Acute Rehab Unit) Ball Memorial Hospital | Muncie ... Conduct utilization review activities for inpatient admissions, outpatient procedures, and ...
RN Case Manager
Evansville, IN · On-site
$83K - $93K/yr
RN Case Manager 📍 Location: Evansville, IN 💼 Schedule: Full-Time | Monday-Friday ⏰ Hours ... Conduct utilization review (UR) and ensure appropriate level of care * Collaborate with physicians ...
Quick apply
RN Case Manager
Evansville, IN · On-site
$83K - $93K/yr
RN Case Manager 📍 Location: Evansville, IN 💼 Schedule: Full-Time | Monday-Friday ⏰ Hours ... Conduct utilization review (UR) and ensure appropriate level of care * Collaborate with physicians ...
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 ... For further information, please review the Know Your Rights notice from the Department of Labor.
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 ... For further information, please review the Know Your Rights notice from the Department of Labor.
RN Care Manager
Evansville, IN · On-site
$85K - $95K/yr
Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS ... Case Management * Discharge Planning * Utilization Review (UR/UM) * Home Health or Care ...
Quick apply
RN Care Manager
Evansville, IN · On-site
$85K - $95K/yr
Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS ... Case Management * Discharge Planning * Utilization Review (UR/UM) * Home Health or Care ...
Case Manager II PRN
Indianapolis, IN · On-site
... utilization review and management, and discharge planning. Essential Functions Care Coordination ... Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
Case Manager II PRN
Indianapolis, IN · On-site
... utilization review and management, and discharge planning. Essential Functions Care Coordination ... Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Indianapolis, IN · On-site
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Internal Medicine Physician General Internist - Physicians Only Apply - Perm
Indianapolis, IN · On-site
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
UR Coordinator (PRN)
Kouts, IN · On-site
... managed care companies, insurance companies and other third party reviewers to establish the length of stay or number of certified days. • Coordinate with the insurance company doctor in appeals ...
UR Coordinator (PRN)
Kouts, IN · On-site
... managed care companies, insurance companies and other third party reviewers to establish the length of stay or number of certified days. • Coordinate with the insurance company doctor in appeals ...
Manager Optum Utilization Review information
What does a Manager of Optum Utilization Review do?
A Manager of Optum Utilization Review oversees a team responsible for evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that all reviews comply with regulatory standards, company policies, and clinical guidelines. Managers also collaborate with healthcare providers, monitor team performance, and help implement process improvements to optimize patient outcomes and resource use. Their role is vital in balancing quality patient care with cost-effective service delivery.
What are the key skills and qualifications needed to thrive as a Manager, Optum Utilization Review, and why are they important?
To thrive as a Manager, Optum Utilization Review, you need a background in healthcare management, clinical expertise (often as an RN or related field), and experience with utilization management processes. Familiarity with utilization review software, electronic health records (EHRs), and relevant certifications such as CCM (Certified Case Manager) or URAC accreditation is typically required. Strong leadership, analytical thinking, and effective communication skills help you guide teams and collaborate with providers and payers. These competencies are crucial for ensuring compliance, optimizing patient care, and achieving organizational goals in a complex healthcare environment.
How does a Manager in Optum Utilization Review typically collaborate with clinical and non-clinical teams to ensure effective case management?
As a Manager in Optum Utilization Review, you will regularly coordinate with clinical teams such as nurses, physicians, and case managers to review patient cases for medical necessity and compliance with policies. You’ll also work closely with non-clinical staff, including data analysts and administrative professionals, to streamline workflows and support accurate documentation. Effective collaboration ensures timely decision-making, helps resolve escalated cases, and supports continuous quality improvement initiatives. This role often requires strong communication and leadership skills to align multidisciplinary teams and achieve organizational goals.
What is the difference between Manager Optum Utilization Review vs Utilization Review Nurse?
| Aspect | Manager Optum Utilization Review | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license, certifications in case management or utilization review | Registered Nurse (RN) license, certifications in case management or utilization review |
| Work Environment | Supervises teams, manages review processes, collaborates with healthcare providers | Conducts patient reviews, assesses medical necessity, documents findings |
| Employer & Industry Usage | Common in health insurance companies, managed care organizations, healthcare providers | Primarily in hospitals, insurance companies, healthcare organizations |
The main difference is that the Manager Optum Utilization Review oversees the review process and team management, while the Utilization Review Nurse focuses on conducting individual patient assessments and reviews. Both roles require nursing credentials and knowledge of healthcare policies, but the manager has additional responsibilities in leadership and process oversight.
What are the most commonly searched types of Optum Utilization Review jobs in Indiana? The most popular types of Optum Utilization Review jobs in Indiana are:
What are popular job titles related to Manager Optum Utilization Review jobs in Indiana? For Manager Optum Utilization Review jobs in Indiana, the most frequently searched job titles are:
- Cvs Health Utilization Management
- Remote Utilization Management Pharmacist
- Telephonic Nurse Case Manager
- Utilization Management Coordinator
- Registered Nurse Utilization Review
- Commission Cvs Health Utilization Management
- Temporary Admission Discharge Nurse
- Remote Cvs Utilization Management Nurse
- Utilization Review Specialist
- Utilization Management
What job categories do people searching Manager Optum Utilization Review jobs in Indiana look for? The top searched job categories for Manager Optum Utilization Review jobs in Indiana are:
What cities in Indiana are hiring for Manager Optum Utilization Review jobs? Cities in Indiana with the most Manager Optum Utilization Review job openings:
Parkview Health rating
7.2
Based on 273 frontline employees who took The Breakroom Quiz
327th of 884 rated healthcare providers
Job description
Summary
Performs clerical, customer service and issue resolution duties within the UM/Reimbursement area. The main focus is to obtain insurance authorizations and complete data entry functions to assist in the improvement of the revenue cycle.
a
Education
Must be a high school graduate or the equivalent with GED.
a
Experience
Must have one year's experience in a medical office, hospital or healthcare setting.
a
Other Qualifications
Demonstrates understanding of managed care concepts. Must have good verbal and written communication skills. Must have excellent people skills and the ability to solve problems efficiently and effectively. Must have good organizational skills and flexibility when dealing with multiple tasks at the same time.
What Parkview Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Parkview Health
Sourced by ZipRecruiter
Parkview Health, headquartered in Fort Wayne, IN, US, operates within the healthcare industry providing a wide range of medical services and community wellness programs. These include primary care, specialty health services, emergency care, rehabilitation, and home health services among others. The non-profit health system was founded in 1878 and continues to serve its surrounding communities with a dedication to quality health and wellness.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Fort Wayne, IN, US
Year founded
1995