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Medicare Utilization Review Jobs in Indiana (NOW HIRING)

Ourhrconnect

Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Medicare policy knowledge and experience Our comprehensive benefits package includes the following:

Ourhrconnect

Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Medicare policy knowledge and experience Our comprehensive benefits package includes the following:

Ourhrconnect

Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Medicare policy knowledge and experience Our comprehensive benefits package includes the following:

Ourhrconnect

Knowledge of medical and utilization review techniques. * Required Licenses and Certifications ... Medicare policy knowledge and experience Our comprehensive benefits package includes the following:

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All JobsMedicare Utilization Review JobsMedicare Utilization Review Jobs in Indiana

Medicare Utilization Review information

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How much do medicare utilization review jobs pay per hour?

As of Aug 7, 2026, the average hourly pay for medicare 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 does a Medicare Utilization Review do?

In a Medicare Utilization Review role, your day-to-day tasks often include reviewing patient medical records to ensure services meet Medicare coverage criteria, evaluating the necessity and efficiency of proposed treatments, and communicating findings with healthcare providers. You’ll also submit detailed reports, coordinate with physicians, case managers, and insurance representatives, and follow up on documentation requests. Frequently, you’ll participate in interdisciplinary team meetings to discuss patient care plans and recommend alternative treatments if needed. This role requires balancing regulatory compliance with effective healthcare delivery, making each day dynamic and rewarding.

What are the key skills and qualifications needed to thrive in Medicare Utilization Review?

To thrive as a Medicare Utilization Review professional, you need a solid background in healthcare (often as an RN or LPN), strong analytical skills, and familiarity with Medicare regulations and guidelines. Experience using utilization management software, electronic health records (EHRs), and claim review systems like InterQual or MCG is typically required. Strong attention to detail, effective communication, and negotiation skills help set candidates apart. These competencies are crucial to ensure compliance, promote accurate claims processing, and support optimal patient care decisions within Medicare standards.

What is a Medicare Utilization Review?

A Medicare Utilization Review job involves evaluating healthcare services to ensure they meet Medicare guidelines for medical necessity, cost-effectiveness, and quality of care. Professionals in this role review patient records, treatment plans, and insurance claims to determine appropriate coverage and prevent fraud or overutilization. They work closely with healthcare providers and insurance companies to ensure compliance with federal regulations. This role helps maintain the integrity of Medicare services while optimizing patient care and cost efficiency. Strong analytical skills and knowledge of medical coding, billing, and Medicare policies are essential for success in this position.

What are popular job titles related to Medicare Utilization Review jobs in Indiana? For Medicare Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Medicare Utilization Review jobs in Indiana look for? The top searched job categories for Medicare Utilization Review jobs in Indiana are:
Medicare Utilization Review jobs near you
Infographic showing various Medicare Utilization Review job openings in Indiana as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $83,687 per year, or $40.2 per hour.

Psychologist

Jane Pauley Community Health Center, Inc.

Anderson, IN • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 19 days ago

Jane Pauley Community Health Center rating

7.5

Company rating: 7.5 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Job description

Empowering communities through accessible, inclusive, and compassionate care, this is the work we do every day.
At Jane Pauley Community Health Center, every role is connected to something bigger. As a Federally Qualified Health Center (FQHC), we deliver integrated, whole-person care to individuals and families across Indiana, regardless of income or insurance status.
Our teams work at the intersection of clinical excellence and community impact, supporting underserved populations while building a culture rooted in collaboration, respect, and growth. Here, you are not just joining a workplace, you are becoming part of a mission that truly matters.
We're seeking a Psychologist that delivers comprehensive behavioral health services within a team-based primary care environment. This role provides direct patient care, clinical leadership, and care coordination while supporting quality, compliance, and continuous improvement across the practice site. The Provider works collaboratively with medical, behavioral health, and operational teams to ensure safe, effective, and accessible care for all patients.
Job Summary
Job Responsibilities (include but are not limited to):
Clinical & Patient Care
  • Provide behavioral health services to patients, including assessment, diagnosis, and treatment.
  • Maintain full-time, on-site clinical coverage as assigned.
  • Provide clinical direction and oversight to team members delivering direct patient care.
  • Coordinate care across inpatient and outpatient settings when appropriate.
  • Participate in patient satisfaction and quality improvement initiatives.

Care Coordination & Referrals
  • Utilize JPCHC and Community Health Network inpatient and outpatient facilities.
  • Refer patients to appropriate providers and services in alignment with organizational standards, patient preference, insurance requirements, and clinical judgment.
  • Collaborate with referring providers to ensure continuity of care.

Quality & Compliance
  • Support the development and implementation of:
    • Quality assurance programs
    • Utilization review
    • Clinical pathways
    • Performance improvement initiatives
  • Ensure care delivery meets federal, state, payer, and accreditation standards.

Education & Team Development
  • Support the education and training of staff in the delivery of behavioral health services.
  • Provide consultation and guidance to clinical and support staff.

Administrative & Leadership Responsibilities
  • Ensure compliance with all licensing, regulatory, and accreditation requirements at the practice site.
  • Support documentation, billing, and payer compliance (including Medicare and Medicaid).
  • Supervise clinical services delivered by non-provider team members under your direction.
  • Assist in recruitment, onboarding, and orientation of new Providers.
  • Participate in utilization review, quality monitoring, and medical staff activities.
  • Provide input into operational and staffing decisions to support safe, effective care delivery.

Required Skills and Qualifications
  • Must hold an active Indiana license as a Psychologist, including Health Service Provider in Psychology (HSPP) designation or be eligible to obtain within an approved timeframe.
  • Doctor of Psychology (PsyD) or Doctor of Philosophy (PhD) in Clinical Psychology, Counseling Psychology, or a related behavioral health field required.
  • Must maintain all required state licensure, DEA (if applicable), and professional certifications in good standing throughout employment.

Why You'll Love Working Here
  • Purpose-driven work that directly impacts access to care across our communities
  • Robust benefits package (medical, dental, vision) designed to support you and your family
  • Generous PTO because we believe caring for others starts with caring for yourself
  • 401(k) with employer contribution to help you plan for what's ahead
  • Life and disability coverage for peace of mind

Here, you are not just filling a role-you are helping shape healthier communities and advancing equitable care every day!

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