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Medical Director Utilization Management Jobs in Indiana

TEEMA Group

Medical Director

Evansville, IN · On-site

$250K - $285K/yr

Medical Director The Medical Director will provide general medical direction and supervision for ... utilization, quality management, performance improvement, pharmacy and therapeutics, peer review ...

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Showing results 21-40

All JobsMedical Utilization Management JobsMedical Director Utilization Management JobsMedical Director Utilization Management Jobs in Indiana

Medical Director Utilization Management information

See Indiana salary details

$12.4K

$221.1K

$339.7K

How much do medical director utilization management jobs pay per year?

As of Aug 22, 2026, the average yearly pay for medical director utilization management in Indiana is $221,113.00, according to ZipRecruiter salary data. Most workers in this role earn between $188,400.00 and $270,700.00 per year, depending on experience, location, and employer.

What is a medical director utilization management?

A Medical Director of Utilization Management is a physician who oversees and ensures the appropriate use of medical resources within a healthcare organization or insurance company. Their responsibilities include reviewing clinical cases, developing utilization review policies, and working with healthcare providers to ensure that treatment plans are medically necessary and cost-effective. They play a key role in balancing patient care quality with regulatory and financial considerations, helping to improve healthcare outcomes and system efficiency.

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

To thrive as a Medical Director Utilization Management, you need a medical degree (MD or DO), board certification, and extensive clinical experience, often in internal medicine or a related specialty. Familiarity with utilization review processes, case management software, and regulatory frameworks such as CMS guidelines is essential. Strong leadership, analytical thinking, and effective communication skills are crucial for guiding teams and collaborating with diverse stakeholders. These competencies ensure appropriate resource utilization, regulatory compliance, and high-quality patient care within healthcare organizations.

How does a medical director utilization management typically collaborate with clinical teams and insurance providers?

A Medical Director in Utilization Management frequently works at the intersection of healthcare providers, clinical teams, and insurance companies. Their role involves reviewing clinical cases, making coverage determinations, and consulting with physicians to ensure that medical treatments are both necessary and cost-effective. Collaboration often includes participating in interdisciplinary meetings, providing guidance on complex cases, and communicating policy updates or clinical guidelines. This ensures that patient care decisions align with best practices, regulatory requirements, and payer policies.

What is the difference between Medical Director Utilization Management vs Medical Director Case Management?

AspectMedical Director Utilization ManagementMedical Director Case Management
CredentialsMedical degree, medical license, possibly board certificationMedical degree, medical license, possibly board certification
Work EnvironmentUtilization review departments, insurance companies, healthcare organizationsCase management teams, hospitals, healthcare providers
Employer & IndustryInsurance companies, managed care organizationsHospitals, healthcare systems, community health agencies
Primary FocusReviewing medical necessity and approving servicesCoordinating patient care and discharge planning

Both roles require medical credentials and involve improving patient care, but Medical Director Utilization Management primarily focuses on reviewing and approving healthcare services for insurance purposes, while Medical Director Case Management emphasizes coordinating ongoing patient care and discharge planning within healthcare settings.

What are popular job titles related to Medical Director Utilization Management jobs in Indiana?

For Medical Director Utilization Management jobs in Indiana, the most frequently searched job titles are:

What job categories do people searching Medical Director Utilization Management jobs in Indiana look for?

The top searched job categories for Medical Director Utilization Management jobs in Indiana are:

What cities in Indiana are hiring for Medical Director Utilization Management jobs?

Cities in Indiana with the most Medical Director Utilization Management job openings:

Medical Director Utilization Management jobs near you
Infographic showing various Medical Director Utilization Management job openings in Indiana as of August 2026, with employment types broken down into 6% As Needed, 88% Full Time, and 6% Part Time. Highlights an 94% In-person, and 6% Hybrid job distribution, with an average salary of $221,113 per year, or $106.3 per hour.

Internal Medicine Physician General Internist - Physicians Only Apply - Perm

SmartDocs Direct

Indianapolis, IN • On-site

Full-time

Re-posted 16 days ago

Job description

Medical Doctors Only Apply. A Internal Medicine Physician General Internist practice is seeking a qualified physician for Indianapolis, IN. This and other physician jobs brought to you by ExactMD.

Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement and credentialing functions for the business unit.

  • Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for capitated providers.
  • Assists Chief Medical Director in planning and establishing goals and policies to improve quality and cost-effectiveness of care and service for members. Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate, and accreditation requirements.
  • Assists the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. Oversees the activities of physician advisors. Utilizes the services of medical and pharmacy consultants for reviewing complex cases and medical necessity appeals. Participates in provider network development and new market expansion as appropriate. Assists in the development and implementation of physician education with respect to clinical issues and policies.
  • Identifies utilization review studies and evaluates adverse trends in utilization of medical services, unusual provider practice patterns, and adequacy of benefit/payment components. Identifies clinical quality improvement studies to assist in reducing unwarranted variation in clinical practice in order to improve the quality and cost of care. Interfaces with physicians and other providers in order to facilitate implementation of recommendations to providers that would improve utilization and health care quality. Reviews claims involving complex, controversial, or unusual or new services in order to determine medical necessity and appropriate payment.
  • Develops alliances with the provider community through the development and implementation of the medical management programs. As needed, may represent the business unit before various publics both locally and nationally on medical philosophy, policies, and related issues. Represents the business unit at appropriate state committees and other ad hoc committees
  • Consults on MCO clinical policy related to Substance Use Disorders and the cases of individual members for the MCM program on a routine basis.

  • Education/Experience: Medical Doctor or Doctor of Osteopathy, board certified preferable in a primary care specialty (Internal Medicine, Family Practice, Pediatrics or Emergency Medicine). The candidate must be an actively practicing physician. Previous experience within a managed care organization is preferred. Course work in the areas of Health Administration, Health Financing, Insurance, and/or Personnel Management is preferred. Experience treating or managing care for a culturally diverse population preferred.

    • Apply