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

Wellpath

Medicaid Support Specialist

Indianapolis, IN · On-site

The role coordinates with operations, utilization management, and claims to prevent unnecessary costs. Responsibilities also include supporting internal process improvements and maintaining ...

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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 Sep 5, 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 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 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 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 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 job categories do people searching Manager Utilization Management jobs in Avon, IN look for?

The top searched job categories for Manager Utilization Management jobs in Avon, IN 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 86% Full Time, and 14% Contract. Highlights an 100% In-person job distribution, with an average salary of $87,283 per year, or $42 per hour.

Physician Family Practice-Without OB - Competitive Salary

Upperline Health

Indianapolis, IN

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 27 days ago

Upperline Health rating

3.5

Company rating: 3.5 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

Job description

ABOUT THE ROLE

Upperline Health is seeking a Primary Care Physician, Value Based Care Director to serve as the clinical leader for our Indianapolis, IN market, driving outcomes, quality, and total cost of care for a high-risk population.

This is a dynamic dual impact role combining direct patient care and clinical leadership and VBC program management focused on improving patient outcomes and scaling best practices across the market.

The position will be based in the Indianapolis area to be able to connect with providers, advise on clinical improvements, and assist in market opportunities and growth — approximately  30-50% in clinics. 

ABOUT US 

Upperline Health is the nation’s largest multi-specialty value-based care organization, serving 500,000+ patients across 20+ states. We deliver coordinated, high-quality care across primary care, podiatry, vascular, endocrinology, wound care, and chronic condition management. 

Our multidisciplinary teams work together to improve outcomes, reduce total cost of care, and make healthcare more connected, accessible, and effective for every patient.

What You’ll Do

  • Oversee the care management and medical management of Upperline Plus patients being seen by Upperline’s Nurse Practitioners in the market 
  • Direct responsibility for your own small panel of highest-risk patients
  • Accountable for value-based care outcomes (e.g., ADK, total cost of care), medical management, care management, utilization management, and quality improvement tools and processes in the market
  • Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews, performance feedback and education on VBC metrics and best practices
  • Review population health data and identify gaps. In collaboration with the Sr. Medical Director and Regional Operations leader, implement solutions to improve delivery of care, decrease hospitalizations, and reduce medical costs
  • Implement and manage new value-based care initiatives
  • Conduct interdisciplinary team meetings to discuss management of the most complex patients (including high-cost and high-risk patients)

Required Experience and Skills

  • Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.)
  • Board certified in Internal Medicine, Family Medicine, Preventative Medicine, or Geriatrics
  • Active license in Indiana and willing to pursue multi-state licensure if needed
  • ~ 5 years of outpatient practice experience, inclusive of caring for adult / senior high-risk, polychronic, clinically complex patient populations
  • Clinically practiced in a VBC model and/or championed programs to improve patient outcomes and reduce risk
  • Must reside in market; be willing and able to provide direct care to a panel of patients and routinely visit clinics and providers within the market

Preferred Experience and Skills

  • Clinical leadership and performance management in a VBC or Population Health company or experience working VBC programs (e.g. Transitional Care Management, Complex Care Management, ED Diversion, Advanced Care Planning, High Risk Patient Outreach)
  • Owned or been part of creating or implementing initiatives, and/or improving processes, protocols, or workflows 

COMPENSATION and BENEFITS 

  • Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience
  • Competitive benefits - comprehensive benefit options include medical, dental and vision, 401K, PTO and parental leave
  • Medical malpractice, licensure and board dues paid annually
  • CME expense allotment

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