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Utilization Management Auditor Jobs in Indiana (NOW HIRING)

Reid Home Health

Pharmacy Technician

Richmond, IN · On-site

$15.75 - $19/hr

This role manages relationships with wholesalers, manufacturers, and Group Purchasing Organization ... Maintains appropriate inventory levels in accordance with GPO contracts, utilization trends, and ...

New

Bsu

IT Operations Coordinator

Muncie, IN · On-site

$16.50 - $17.84/hr

Manage and complete problem reports and support tickets via the ServiceNow system. 5. Hire, train ... Provide utilization reporting from the Webex system. Fill in as needed in the absence of the ...

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Utilization Management Auditor information

What is a utilization management auditor?

A Utilization Management Auditor is a healthcare professional responsible for reviewing medical records, claims, and utilization data to ensure that healthcare services provided to patients are necessary, appropriate, and comply with established guidelines and policies. They help identify overuse, underuse, or misuse of medical resources and ensure regulatory compliance. Utilization Management Auditors work closely with healthcare providers, insurance companies, and regulatory agencies to improve the quality and cost-effectiveness of patient care.

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

To thrive as a Utilization Management Auditor, you need a strong background in healthcare administration, case management, and medical coding, often supported by a clinical degree or certification such as RN, LPN, or RHIA. Familiarity with utilization management software, electronic health records (EHRs), and regulatory standards like CMS guidelines is essential. Analytical thinking, attention to detail, and effective communication are crucial soft skills for identifying compliance issues and collaborating with healthcare teams. These skills ensure accurate audits, regulatory compliance, and optimal resource utilization within healthcare organizations.

What are some common challenges faced by utilization management auditors and how can they be addressed?

Utilization Management Auditors often encounter challenges such as keeping up with constantly changing healthcare regulations and payer requirements, interpreting complex medical documentation, and ensuring compliance with both internal and external policies. To address these challenges, auditors should engage in ongoing professional development, collaborate closely with clinical and administrative teams for accurate information, and make use of robust audit tools and resources. Effective communication and a proactive approach to regulatory changes can help streamline the audit process and maintain high standards of accuracy.

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

AspectUtilization Management AuditorUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications like CCM or CUCLicensed Registered Nurse (RN), often with additional certifications
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinics, insurance companies, often in clinical settings
Primary FocusAuditing and reviewing utilization data for compliance and cost managementAssessing patient care needs and determining appropriate services

While both roles involve healthcare utilization, the Utilization Management Auditor primarily reviews data for compliance and cost efficiency, whereas the Utilization Review Nurse focuses on patient care assessments. Both require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ.

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

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

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

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

What cities in Indiana are hiring for Utilization Management Auditor jobs?

Cities in Indiana with the most Utilization Management Auditor job openings:

Utilization Management Auditor jobs near you
Infographic showing various Utilization Management Auditor job openings in Indiana as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, and 4% Contract. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution.

Unit Manager/Medical Records RN/LPN

American Senior Communities

Fort Wayne, IN • On-site

$63K - $63K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 2 days ago

New

American Senior Communities rating

5.5

Company rating: 5.5 out of 10

Based on 128 frontline employees who took The Breakroom Quiz

821st of 893 rated healthcare providers

Job description

LPN Unit Manager Opportunity at Sage Bluff
LPN/RN
The Unit Manager assumes responsibility and accountability for the nursing care of all residents on the assigned unit. The Unit Manager supervises licensed nurses and other nursing personnel in the delivery of care. Manages unit in accordance with company philosophy, standards of professional nursing practices, and all federal and state laws and regulations.
The Medical Records Coordinator is responsible for the successful utilization of the electronic medical record (EMR). The Medical Records Coordinator will work with physicians, office staff, nursing management and staff to utilize the EMR through auditing, analysis, and training.
The American Health Care Association recently recognized ASC as the 12th largest provider, yet #2 in quality among the nation's 20 largest skilled nursing care companies. What that means for our team members is the opportunity to work in a company supported by strong clinical standards, proven processes, and a company committed to excellence. It's something we're incredibly proud of, and it reflects the kind of organization you can build a career with.
Skills Needed:
  • Supportive Presence: Create a comforting and engaging atmosphere for our residents.
  • Leadership: Management experience or willingness and desire to learn proper approaches to managing staff. Passion for teaching, leading and mentoring staff.
  • Detail Oriented: Ability to use clinical knowledge to exceed the needs of the residents, resident families and staff.
  • Collaboration: Promote communication and interdisciplinary approaches to resident care.

Requirements:
  • Graduate of an accredited school of nursing.
  • Indiana LPN license or ability to obtain an Indiana license.
  • Demonstrates C.A.R.E. values to our residents, family members, customers and staff. Compassion, Accountability, Relationships and Excellence

Benefits and perks include:
  • Competitive Compensation: Access your earnings before payday. Take advantage of lucrative employee referral bonus programs, 401(k), FSA program, free life insurance, PTO exchange for pay programs and more.
  • Health & Wellness: Medical coverage as low as $25, vision and dental insurance. Employee Assistance Program to help manage personal or work-related issues, as well as Workforce Chaplains to provide support in the workplace and Personalized Wellness Coaching.
  • Life in Balance: Holiday pay and PTO with opportunities to earn additional PTO. Employee Discount Programs that allow you to save on travel, retail, entertainment, food and much more.
  • Career Growth: Access to preceptors and mentorship programs, clinical and leadership development pathways, education partnerships with colleges and universities across the state like Ivy Tech and Purdue Global, financial assistance for continuing education, company sponsored scholarship programs, and tuition reimbursement.
  • Team Culture: C.A.R.E. Values: Compassion, Accountability, Relationships and Excellence carrying a legacy for improving the lives of Seniors across Indiana. Celebrate the hard work you and your team put in each day through employee recognition events and monthly and annual awards.

*Full-Time and Part-Time Benefits may vary, terms and conditions apply
About American Senior Communities
Compassion, Accountability, Relationships and Excellence are the core values for American Senior Communities. These words not only form an acronym for C.A.R.E., but they are also our guiding principles and create the framework for all our relationships with customers, team members and community at large.
American Senior Communities has proudly served our customers since the year 2000, with a long history of excellent outcomes. Team members within each of our 100+ American Senior Communities take great pride in our Hoosier hospitality roots, and it is ingrained in everything we do. As leaders in senior care, we are not just doing a job but following a calling.
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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About American Senior Communities

Sourced by ZipRecruiter

Compassion, Accountability, Relationships and Excellence are the core values for American Senior Communities. These words not only form an acronym for C.A.R.E., they are our guiding principles and create the framework for all our relationships with customers, team members and community at large. American Senior Communities has proudly delivered patient centered care since the year 2000, with a long history of excellent outcomes. Each of our 80+ American Senior Community is part of the neighborhood in which it exists. Our leaders and staff live in surrounding areas and know the community well. We value the same things in life that you do. The foundation of our senior living communities is based on the knowledge that we'll be part of your neighborhood for many, many years. We take great pride in our hospitality and it is ingrained in everything we do. As partners in senior care, we are not just doing a job, but following a calling.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Indianapolis, IN, US

Year founded

2000

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