UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
Clinical Denial Analyst (RN)
Evansville, IN · On-site
$28.71 - $40.19/hr
Minimum of two (2) years performing utilization review, charge audit, case management or similar ... Registered Nurse // HRS // Healthcare Resources // UM // Utilization Management // Case Management ...
Clinical Denial Analyst (RN)
Evansville, IN · On-site
$28.71 - $40.19/hr
Minimum of two (2) years performing utilization review, charge audit, case management or similar ... Registered Nurse // HRS // Healthcare Resources // UM // Utilization Management // Case Management ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred.Current ACM-RN, CCM preferred.Experience with InterQual or MCG criteria, discharge ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred.Current ACM-RN, CCM preferred.Experience with InterQual or MCG criteria, discharge ...
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
New
Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred. Current ACM-RN, CCM preferred. Experience with InterQual ® or MCG ® criteria ...
New
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... Bachelor's degree in related field with 3-5 years' experience * LPN or RN experience preferred ...
... Management and Team. * Provides education to nursing staff. ;eadership team, and providers ... Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 ...
... Management and Team. * Provides education to nursing staff. ;eadership team, and providers ... Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 ...
... Management and Team. * Provides education to nursing staff. ;eadership team, and providers ... Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 ...
... Management and Team. * Provides education to nursing staff. ;eadership team, and providers ... Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 ...
... Management and Team. * Provides education to nursing staff. ;eadership team, and providers ... Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 ...
... Management and Team. * Provides education to nursing staff. ;eadership team, and providers ... Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 ...
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... N experience preferredHoursMonday - Friday (8:30am-5:00pm)This position is on-site at RHI The ...
Quick apply
Functions as liaison with payer representatives to manage the rehabilitation process in keeping ... N experience preferredHoursMonday - Friday (8:30am-5:00pm)This position is on-site at RHI The ...
Participate in quality improvement, utilization management, and patient safety initiatives*Collaborate with hospital leadership, nursing, and medical staff committees*Support implementation of ...
Participate in quality improvement, utilization management, and patient safety initiatives*Collaborate with hospital leadership, nursing, and medical staff committees*Support implementation of ...
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
RN-CASE MANAGEMENT
Terre Haute, IN · On-site
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
RN-CASE MANAGEMENT
Terre Haute, IN · On-site
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
RN-CASE MANAGEMENT
Terre Haute, IN · On-site
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
RN-CASE MANAGEMENT
Terre Haute, IN · On-site
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
RN-CASE MANAGEMENT
Terre Haute, IN · On-site
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
RN-CASE MANAGEMENT
Terre Haute, IN · On-site
The RN House Care Manager plays a key role on the Case Management team! Join us as we provide ... needs, utilization management, transfer coordination, and discharge planning. * Issue Medicare ...
Utilization Management Nurse information
See Indiana salary details
$37.1K - $47.8K
15% of jobs
$47.8K - $58.6K
8% of jobs
$60.1K is the 25th percentile. Wages below this are outliers.
$58.6K - $69.3K
15% of jobs
The median wage is $76.1K / yr.
$69.3K - $80K
20% of jobs
$80K - $90.7K
11% of jobs
$96.1K is the 75th percentile. Wages above this are outliers.
$90.7K - $101.5K
13% of jobs
$101.5K - $112.2K
5% of jobs
$112.2K - $122.9K
3% of jobs
$122.9K - $133.7K
4% of jobs
$133.7K - $144.4K
3% of jobs
$144.4K - $155.1K
3% of jobs
$37.1K
$85.1K
$155.1K
How much do utilization management nurse jobs pay per year?
As of Aug 17, 2026, the average yearly pay for utilization management nurse in Indiana is $85,148.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,400.00 and $99,400.00 per year, depending on experience, location, and employer.
What is a utilization management nurse?
A Utilization Management Nurse is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services provided to patients. They review medical records and treatment plans to ensure that care meets established guidelines and is cost-effective. Utilization Management Nurses work with healthcare providers, insurance companies, and patients to coordinate care and prevent unnecessary procedures or hospitalizations. Their goal is to support high-quality patient care while managing healthcare costs.
What does a utilization management nurse do?
A utilization management nurse ensures that healthcare services are administered appropriately. Their job responsibilities include working in a hospital, health practice, or other clinical setting reviewing patient clinical records, drafting clinical appeals, and overseeing staff members. The qualifications for a utilization management nurse include a nursing degree and a registered nursing license. Most people in this job also have career experience in case management and utilization review.
What are the key skills and qualifications needed to thrive as a utilization management nurse?
To thrive as a Utilization Management Nurse, you need a registered nursing license, strong clinical judgment, and experience in case management or utilization review. Familiarity with medical management software, InterQual or Milliman guidelines, and insurance authorization processes is typically required. Excellent analytical thinking, communication, and negotiation skills help you coordinate with providers and advocate for patients. These competencies ensure appropriate resource use, compliance with regulations, and optimal patient outcomes.
What are some common challenges a utilization management nurse faces when coordinating care between providers and insurance companies?
A Utilization Management Nurse often navigates the challenge of balancing patient advocacy with insurance guidelines, ensuring that care recommendations meet both clinical standards and payer requirements. Communicating complex medical information to both providers and insurance representatives can be demanding, especially when there are disagreements about coverage or medical necessity. Additionally, staying updated on changing policies and maintaining thorough documentation under tight deadlines are frequent aspects of the role. Strong collaboration skills and attention to detail are essential for success in this position.
What is the difference between Utilization Management Nurse vs Case Manager?
| Aspect | Utilization Management Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certifications in utilization review | RN license, case management certification often preferred |
| Work Environment | Insurance companies, healthcare organizations, utilization review departments | Hospitals, community health agencies, insurance companies |
| Primary Focus | Reviewing medical necessity and appropriateness of services | Coordinating patient care and discharge planning |
Utilization Management Nurses primarily focus on reviewing medical necessity and approving healthcare services, while Case Managers coordinate patient care and facilitate discharge planning. Both roles require RN licensure and work within healthcare or insurance settings, but their core responsibilities differ in scope and focus.
More about Utilization Management Nurse jobs
What are the most commonly searched types of Utilization Management Nurse jobs in Indiana?
The most popular types of Utilization Management Nurse jobs in Indiana are:
What are popular job titles related to Utilization Management Nurse jobs in Indiana?
For Utilization Management Nurse jobs in Indiana, the most frequently searched job titles are:
- Utilization Review Physician
- Manager Utilization Management
- Remote Admissions Nurse
- Contract Utilization Review Nurse
- No Experience Utilization Management Nurse
- Registered Nurse Utilization Review
- Utilization Review Rn
- Per Diem Utilization Review Nurse
- Remote Utilization Review Nurse
- Utilization Management Nurse Consultant
What job categories do people searching Utilization Management Nurse jobs in Indiana look for?
The top searched job categories for Utilization Management Nurse jobs in Indiana are:
- Remote Preservice Review Nurse
- Lpn Utilization Review Nurse
- Remote Occupational Therapy Utilization Review
- Online Remote Mds
- Volunteer Aetna Utilization Review Nurse
- Manager Optum Utilization Review
- Optum Utilization Review Nurse
- Remote Utilization Review Nurse Practitioner
- Discharge Planner Utilization Review
- Seasonal Remote Utilization Review
What cities in Indiana are hiring for Utilization Management Nurse jobs?
Cities in Indiana with the most Utilization Management Nurse job openings:
What are popular job titles related to Utilization Management Nurse jobs in IN?
For Utilization Management Nurse jobs in IN, the most frequently searched job titles are:
Schneck Medical Center rating
7.2
Based on 14 frontline employees who took The Breakroom Quiz
431st of 1,060 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.
What Schneck Medical Center employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Schneck Medical Center
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Seymour, IN, US
Year founded
1911