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Nurse Practitioner Utilization Review Jobs in Indiana

... oversees utilization management including, but not limited to: utilization review, case ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...

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Nurse Practitioner Utilization Review information

See Indiana salary details

$67.6K

$127.9K

$200.3K

How much do nurse practitioner utilization review jobs pay per year?

As of Aug 14, 2026, the average yearly pay for nurse practitioner utilization review in Indiana is $127,861.00, according to ZipRecruiter salary data. Most workers in this role earn between $105,600.00 and $145,100.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive in the nurse practitioner utilization review position, and why are they important?

To thrive as a Nurse Practitioner Utilization Review, you need advanced clinical knowledge, current NP licensure, and expertise in reviewing medical records for appropriateness of care. Familiarity with utilization management software, ICD-10/CPT coding, and case management systems is typically required, along with relevant certifications such as URAC or CCM. Strong analytical thinking, attention to detail, effective written communication, and collaboration skills help you excel in evaluating care plans and working with multi-disciplinary teams. These abilities ensure accurate assessment of healthcare services, optimal resource use, and regulatory compliance within healthcare organizations.

What are common day-to-day responsibilities for a nurse practitioner utilization review?

A Nurse Practitioner Utilization Review typically spends their day evaluating patient records, determining medical necessity of treatments, and ensuring care meets established guidelines and payer requirements. This role involves frequent collaboration with physicians, case managers, and insurance representatives to clarify or appeal decisions as needed. You may also participate in team meetings, develop recommendations for optimizing utilization, and provide education to clinical staff regarding documentation or policy changes. The work is often remote or office-based, with a predictable schedule and minimal direct patient contact. This structure allows for a balanced workload and a focus on analytical aspects of patient care.

What is a nurse practitioner utilization review?

A Nurse Practitioner Utilization Review (NP UR) job involves evaluating medical records to ensure treatments are medically necessary, cost-effective, and compliant with healthcare guidelines. NP UR professionals work with insurance companies, healthcare organizations, or government agencies to review patient care decisions, approve or deny claims, and recommend alternative treatments when needed. They use clinical expertise to assess whether services align with best practices and healthcare policies. This role is typically non-clinical, involving case reviews, documentation, and collaboration with healthcare providers. It helps improve patient care efficiency while controlling costs.

What are the most commonly searched types of Nurse Practitioner Utilization Review jobs in Indiana?

The most popular types of Nurse Practitioner Utilization Review jobs in Indiana are:

Infographic showing various Nurse Practitioner Utilization Review job openings in Indiana as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $127,861 per year, or $61.5 per hour.

UTILIZATION REVIEW RN

Schneck Medical Center

Seymour, IN • On-site

Other

Re-posted 10 days ago


Schneck Medical Center rating

7.2

Company rating: 7.2 out of 10

Based on 14 frontline employees who took The Breakroom Quiz

428th of 1,059 rated hospitals


Job description

Job Details

SALARY / 8:00am - 5:00pm / with on-call, weekend, & holiday rotation required

ELIGIBLE FOR $2,000 SIGN-ON BONUS!

JOB REQUIREMENTS EDUCATION Minimum: Graduate of accredited school of nursing (BSN Preferred) Preferred: Bachelors Degree in Nursing with case management certification

LICENSE/CERTIFICATION Licensed RN in State of Indiana. Certification plan in place within 24 months of hire.

EXPERIENCE Minimum: 2-3 years of acute care clinical experience Preferred: 3-5 years of acute care clinical experience with strong knowledge of medical necessity criteria and payer requirements

JOB DUTIES

  • Utilization Review and Medical Necessity
  • Concurrent Review and Length of Stay Management
  • Retrospective Review
  • Payer Communication & Authorization
  • Denials Management and Appeals

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.


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