Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Prior utilization review, case management, or payer review experience preferred * Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines * Solid understanding of clinical care ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Minimum of 2 years of utilization review experience in a hospital setting required ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
Quick apply
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
The Utilization Reviewer contributes to assessment and planning by performing a thorough review of ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
... you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient ... UR contacts external case managers/managed care organizations for certification of insurance ...
RN Utilization Review
$73K - $75K/yr
To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive ...
New
RN Utilization Review
$73K - $75K/yr
To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive ...
New
Appeals Pharmacist (Remote)
West Lafayette, IN · On-site +1
$51.25 - $62.50/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Appeals Pharmacist (Remote)
West Lafayette, IN · On-site +1
$51.25 - $62.50/hr
Experience: Prior managed care or utilization management experience preferred - retail and hospital pharmacists with strong clinical and documentation skills are encouraged to apply. * Skills:
Physician Advisor
Munster, IN · On-site
The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical ...
Physician Advisor
Munster, IN · On-site
The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical ...
Utilization Management 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 jobs pay per year?
As of Jun 9, 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 the Utilization Management position, 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 a Utilization Management job?
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:
- No Experience Utilization Management Nurse
- Part Time Utilization Review Nurse
- Registered Nurse Utilization Review
- Remote Utilization Management
- Remote Utilization Management Nurse
- Flex Schedule Remote Utilization Review Nurse
- Commission Cvs Health Utilization Management
- Utilization Review Physician
- Weekday Cvs Utilization Management Nurse
- No Experience Utilization Review Nurse
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:
- Lpn Utilization Review
- Lpn Utilization Review Work From Home
- Aetna Utilization Review Nurse
- Director Optum Utilization Review
- Utilization Review Manager
- Anthem Utilization Review Nurse
- Utilization Review Case Manager
- Remote Aetna Utilization Review Nurse
- Remote Aetna Utilization Review
- Chart Utilization Review
What cities in Indiana are hiring for Utilization Management jobs? Cities in Indiana with the most Utilization Management job openings:
Part-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 20 days ago
Job description
Employment Type:Part timeShift:Rotating ShiftDescription:This is a remote position but will need onsite training in Mishawaka Indiana.
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Shift: PRN/Days - 8 hr shift
Considering local candidates only!!!
Why Choose Saint Joseph Health System?
At Saint Joseph Health System, our values guide every decision we make. Even when challenges arise, we remain committed to our mission: caring for every person who needs us. We invest in our people, our technology, and our capabilities so we can continue delivering exceptional, compassionate care to our communities.
Tuition reimbursement for all full-time and part-time colleagues starting on day one
Comprehensive benefits beginning day one (Medical, Dental, Vision, PTO, Life Insurance, STD/LTD, and more)
Retirement savings plan with employer match
Generous paid time off program plus 7 paid holidays
No mandatory overtime
Employee referral incentive program
Access to state-of-the-art equipment, unlimited CEUs, and a supportive team-focused work environment
- Conduct clinical reviews of patient records to evaluate medical necessity, appropriateness of admission, treatment, and length of stay across all payor types
- Apply standardized criteria, regulatory guidelines, and insurance requirements to support reimbursement and compliance
- Collaborate with physicians, nursing staff, and interdisciplinary teams to ensure appropriate resource utilization and care planning
- Review admissions and ongoing patient cases; recommend or escalate cases that do not meet criteria to leadership or the Utilization Review Committee
- Facilitate timely discharges, transfers, and recertifications when level of care is no longer appropriate
- Partner with Medicare, Medicaid, and private insurers to ensure accurate documentation and reimbursement processes
- Respond to denials and authorization changes by reviewing medical records and communicating outcomes to care teams and patients
- Identify trends and utilization concerns; contribute to performance improvement and quality initiatives
- Maintain accurate records, compile reports, and support utilization review program operations
- Provide education to clinical staff on documentation requirements, coverage guidelines, and utilization processes
- Support compliance with all regulatory, accreditation, and organizational standards
- Participate in committee meetings and assist in development of utilization review plans and processes
- Graduate of an accredited Registered Nurse (RN) program; Bachelor's Degree in Nursing preferred
- Active RN license (state-specific requirement applies)
- Minimum of 2 years of acute care nursing experience
- Prior utilization review, case management, or payer review experience preferred
- Strong knowledge of Medicare, Medicaid, and commercial insurance guidelines
- Solid understanding of clinical care practices, diagnoses, treatment modalities, and hospital operations
- Excellent communication skills with the ability to collaborate effectively across teams
- Strong analytical and critical thinking skills to assess clinical appropriateness and compliance
- Proficiency in computer systems and Microsoft Office applications
- Ability to manage multiple priorities in a fast-paced healthcare environment
- Flexibility to adapt to changing schedules, workflows, and departmental needs
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.