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Manager Utilization Management Jobs in Avon, IN (NOW HIRING)

ScionHealth

Case Manager II PRN

Indianapolis, IN · On-site

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 ...

Elevance Health

Sr Test Analyst PBM

Indianapolis, IN · On-site

Validation of Formulary, Utilization Management & Drug List setup using Claims/Query testing. * Identify, triage, and collaborate with business and adjudication teams to resolve defects efficiently ...

Elevance Health

Sr Test Analyst PBM

Indianapolis, IN · Hybrid

Validation of Formulary, Utilization Management & Drug List setup using Claims/Query testing. * Identify, triage, and collaborate with business and adjudication teams to resolve defects efficiently ...

Elevance Health

Sr Test Analyst PBM

Indianapolis, IN · Hybrid

Validation of Formulary, Utilization Management & Drug List setup using Claims/Query testing. * Identify, triage, and collaborate with business and adjudication teams to resolve defects efficiently ...

MedSource

IM Physician

Indianapolis, IN · On-site

Participate in quality improvement, utilization management, and patient safety initiatives *Collaborate with hospital leadership, nursing, and medical staff committees *Support implementation of ...

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Showing results 21-40

All JobsUtilization Management JobsManager Utilization Management JobsManager Utilization Management Jobs in Avon, IN

Manager Utilization Management information

See Avon, IN salary details

$37.4K

$87.3K

$160.6K

How much do manager utilization management jobs pay per year?

As of Aug 10, 2026, the average yearly pay for manager utilization management in Avon, IN is $87,283.00, according to ZipRecruiter salary data. Most workers in this role earn between $57,100.00 and $105,000.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a manager utilization management?

To thrive as a Manager Utilization Management, you need a thorough understanding of healthcare regulations, utilization review processes, and case management, often supported by a clinical degree (such as RN) and relevant experience. Familiarity with utilization management software, claims processing systems, and potentially certifications like CCM (Certified Case Manager) or ACM (Accredited Case Manager) is important. Strong leadership, analytical thinking, and effective communication help you guide teams and collaborate with providers and payers. These skills ensure efficient resource use, compliance, and quality patient care within managed care organizations.

What is the difference between Manager Utilization Management vs Utilization Review Nurse?

AspectManager Utilization ManagementUtilization Review Nurse
CredentialsRN, often with management or utilization review certificationsRN, with certifications in utilization review or case management
Work EnvironmentSupervises teams, manages policies, oversees utilization review processesPerforms patient chart reviews, assesses medical necessity, collaborates with providers
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance companies, healthcare organizations
Search & Comparison IntentYesYes

While both roles focus on utilization review, the Manager Utilization Management oversees teams and policies, ensuring efficient resource use, whereas the Utilization Review Nurse conducts patient-specific reviews to determine medical necessity. The manager role involves leadership and strategic planning, while the nurse role is more clinical and review-focused.

What are some common challenges faced by a manager utilization management, and how can they effectively address them?

Managers in Utilization Management often encounter challenges such as balancing quality patient care with cost containment, navigating evolving healthcare regulations, and managing diverse teams. To effectively address these issues, successful managers develop strong communication skills, stay updated on industry standards, and foster collaboration between clinical and administrative staff. Implementing robust training programs and utilizing data-driven decision-making can also help ensure compliance and improve overall team performance.

What does a manager utilization management do?

A Manager of Utilization Management oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They lead a team that reviews medical claims and care plans to ensure compliance with clinical guidelines and regulatory requirements. Their role often involves collaborating with physicians, nurses, insurance companies, and other stakeholders to optimize patient outcomes while managing healthcare costs. Additionally, they are responsible for implementing policies, training staff, and ensuring that utilization management activities align with organizational goals.
What are popular job titles related to Manager Utilization Management jobs in Avon, IN? For Manager Utilization Management jobs in Avon, IN, the most frequently searched job titles are:
What cities near Avon, IN are hiring for Manager Utilization Management jobs? Cities near Avon, IN with the most Manager Utilization Management job openings:
Manager Utilization Management jobs near you
Infographic showing various Manager Utilization Management job openings in Avon, IN as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 15% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $87,283 per year, or $42 per hour.

Utilization Review Coordinator PRN

Neuropsychiatric Hospitals

Indianapolis, IN • On-site

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 16 days ago

Job description

About Us
Healing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
Overview
NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
  • Competitive pay rates
  • Medical, Dental, and Vision Insurance
  • NPH 401(k) plan with up to 4% Company match
  • Employee Assistance Program (EAP) Programs
  • Generous PTO and Time Off Policy
  • Special tuition offers through Capella University
  • Work/life balance with great professional growth opportunities
  • Employee Discounts through LifeMart

Responsibilities
  • Filing documents as needed.
  • Initial Precertification with payors.
  • Concurrent Clinical review with payors.
  • Document in the electronic system daily in real time.
  • Admission audit.
  • Ensures that CON's/RON's and CMS certifications are completed by provider.
  • Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
  • Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
  • Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
  • Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
  • Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
  • Complies with hospital expectations regarding ethical behavior and standards of conduct.
  • Complies with federal and hospital requirements in the areas of protected health information and patient information.
  • Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
  • Provides education to nursing staff. ;eadership team, and providers regarding documentation.
  • Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.

Qualifications
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW

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