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Utilization Management Jobs in Indiana (NOW HIRING)

UHS

MGR - UTILIZATION REVIEW / MGMT

Bloomington, IN · On-site

Responsibilities The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements ...

Beacon Health System

W/Alt UM Nurse (BHS)

Granger, IN · On-site

Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial Hospital, physicians, third-party payers and auditors to ensure information needs are met. This ...

Beacon Health System

W/Alt UM Nurse (BHS)

Granger, IN · On-site

Reports to the Manager, Utilization Management Department. Serves as a liaison between Memorial Hospital, physicians, third-party payers and auditors to ensure information needs are met. This ...

Humana

Compliance UM Nurse (Wed - Sun)

Indianapolis, IN · On-site

Become a part of our caring community The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent ...

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All JobsUtilization Management JobsUtilization Management Jobs in Indiana

Utilization Management information

See Indiana salary details

$37.1K

$85.1K

$155.1K

How much do utilization management jobs pay per year?

As of Aug 10, 2026, the average yearly pay for utilization management 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 are the key skills and qualifications needed to thrive in utilization management, and why are they important?

To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.

What is utilization management?

A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.

What are the typical daily responsibilities of a utilization management professional?

As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.

What are the most commonly searched types of Utilization Management jobs in Indiana? The most popular types of Utilization Management jobs in Indiana are:
What are popular job titles related to Utilization Management jobs in Indiana? For Utilization Management jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Indiana look for? The top searched job categories for Utilization Management jobs in Indiana are:
What cities in Indiana are hiring for Utilization Management jobs? Cities in Indiana with the most Utilization Management job openings:
Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Indiana as of August 2026, with employment types broken down into 84% Full Time, 13% Part Time, 1% Temporary, and 2% Contract. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution, with an average salary of $85,148 per year, or $40.9 per hour.

Utilization Management Nurse

SIHO Insurance Services

Columbus, IN

Full-time

Re-posted 13 days ago

Job description

Job Title:  Utilization Management Nurse
Reports To: Manager of Utilization Management
Employment Type:  Full-Time, Exempt 

Brief Description of Duties:     
This position is reserved for a licensed Registered Nurse who will perform the Utilization Management (UM) services for SIHO (and affiliated business lines’) members. This individual’s primary role is to ensure that health care services are administered with quality, cost effectiveness, and compliance to plan guidelines are maintained. By performing review of services prospectively, retrospectively, and throughout the episode of care, the UM nurse will make coverage determinations influencing how services are allocated to SIHO’s various member populations.  A candidate’s ability to perform quality reviews within strict efficiency standards is required for this position.  Key responsibilities are as follows: 
- Pre-service, concurrent, and post-service review of necessity of health care services utilizing enrollee medical records and established guidelines set by SIHO and/or state and federal (CMS) guidelines
- Interaction with the member, health care provider, and/or other care team members to complete reviews in most time-efficient manner
- Interaction with the SIHO Medical Director as needed to ensure proper medical necessity decisions are made in a timely manner
- Appropriate documentation of the entire review process utilizing the established documentation system and desk procedures to guarantee accurate reporting metrics and data integrity
- Complete case review and elevation to determinations that are rendered within the contractual and regulatory turnaround times established by SIHO and CMS
- Assist to resolve problems and provide guidance to members of the team and cohorts
-Interpret and abide by organizational policies and procedures; review work regularly to ensure that policies and guidelines are appropriately applied
-Act as a clinical resource to the department and other organization members for services pertaining to medical management, utilization review, and medical necessity
- Act and perform within the scope of professional nursing practice; is responsible in supporting and participating in department strategies and efforts focused on quality improvement
- Responsible for the early identification and assessment of members for inclusion in disease management or care management programs
- Assist in the identification and reporting of Potential Quality of Care concerns and Fraud, Waste and Abuse incidents
- Work as an interdisciplinary team member within Medical Management for all lines of business and commercial group plans 

Minimum Skills Requirement: 
- Registered Nurse with current, unrestricted license in primary state of employment (position may require additional licensing in other states as necessary)Previous UM or Health Plan experience highly preferred
- Desire to work in a fast-paced environment with focus on efficiency while maintaining quality
- Self-directed organization and prioritization skills, and independent time management skills required
- Sound clinical background with experience in the clinical field
- Excellent verbal and written communication skills
- Microsoft Office Experience: Outlook, Word, Excel

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.