Work From Home Work From Home Work From Home, Indiana 46544 The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization ...
Work From Home Work From Home Work From Home, Indiana 46544 The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization ...
Utilization Management Representative I Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions ...
Utilization Management Representative I Utilization Management Representative I Location : This role enables associates to work virtually full-time, except for required in-person training sessions ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
Utilization Management Rep I Utilization Management Representative I Shift: Monday-Friday (Must be willing to work weekends and holidays) Location: Virtual: This role enables associates to work ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
Utilization Management Rep I Utilization Management Representative I Shift: Monday-Friday (Must be willing to work weekends and holidays) Location: Virtual: This role enables associates to work ...
Utilization Management Representative I - Backoffice Support
Indianapolis, IN · On-site
$15.96 - $23.94/hr
Utilization Management Representative I - Backoffice Support Utilization Management Representative I - Backoffice Support Location : This role enables associates to work virtually full-time, except ...
Utilization Management Representative I - Backoffice Support
Indianapolis, IN · On-site
$15.96 - $23.94/hr
Utilization Management Representative I - Backoffice Support Utilization Management Representative I - Backoffice Support Location : This role enables associates to work virtually full-time, except ...
Registered Nurse Utilization Review
Carmel, IN · On-site +1
$50 - $52/hr
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and holidays. Must be able to commit to training requirements, which is Monday-Friday for 8 hours/day for ...
Registered Nurse Utilization Review
Carmel, IN · On-site +1
$50 - $52/hr
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and holidays. Must be able to commit to training requirements, which is Monday-Friday for 8 hours/day for ...
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and holidays. Must be able to commit to training requirements, which is Monday-Friday for 8 hours/day for ...
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and holidays. Must be able to commit to training requirements, which is Monday-Friday for 8 hours/day for ...
Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...
Assigned projects span drug coverage administration, Preferred Drug List (PDL) management, prior authorization, utilization management, drug utilization review, clinical criteria configuration, and ...
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
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What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. * Scheduling of Peer-to-Peers to facilitate Medical Director ...
Responsibilities exclude conducting any utilization management review activities which require interpretation of clinical information. * Scheduling of Peer-to-Peers to facilitate Medical Director ...
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 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 ...
Assess and redesign end-to-end processes across claims, enrollment, billing, customer service, utilization management, care management, and pharmacy or pharmacy benefit manager operations * Translate ...
Assess and redesign end-to-end processes across claims, enrollment, billing, customer service, utilization management, care management, and pharmacy or pharmacy benefit manager operations * Translate ...
Trend & Analytics Consultant Senior (Actuarial Business Consultant)
Indianapolis, IN · Hybrid
$100K - $122K/yr
Experience with utilization management data strongly preferred. * Experience with Utilization Management systems and Behavioral Health programs highly desired. * 4 years of database development and ...
Trend & Analytics Consultant Senior (Actuarial Business Consultant)
Indianapolis, IN · Hybrid
$100K - $122K/yr
Experience with utilization management data strongly preferred. * Experience with Utilization Management systems and Behavioral Health programs highly desired. * 4 years of database development and ...
Experience in Behavioral or Mental Health * 3-5 years of case and/or utilization management experience * CCM (Certified Case Manager) is a PLUS Additional Information If you are interested in ...
Experience in Behavioral or Mental Health * 3-5 years of case and/or utilization management experience * CCM (Certified Case Manager) is a PLUS Additional Information If you are interested in ...
Utilization Review RN
Indianapolis, IN · On-site
$30 - $34/hr
Strong computer skills, positive attitude, and ability to hit high production goals is what the manager is looking for here. Expected to review 20 cases a day with a 95% accuracy rate. Responsible ...
Utilization Review RN
Indianapolis, IN · On-site
$30 - $34/hr
Strong computer skills, positive attitude, and ability to hit high production goals is what the manager is looking for here. Expected to review 20 cases a day with a 95% accuracy rate. Responsible ...
Utilization Review RN
Indianapolis, IN · On-site
May also manage appeals for services denied. * Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with ...
Utilization Review RN
Indianapolis, IN · On-site
May also manage appeals for services denied. * Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with ...
Utilization Management experience. * Certification as a Case Manager. * Minimum 2 years' experience in acute care setting. * Experience with (Microsoft Office) and/or ability to learn new computer ...
Utilization Management experience. * Certification as a Case Manager. * Minimum 2 years' experience in acute care setting. * Experience with (Microsoft Office) and/or ability to learn new computer ...
Chief Medical Officer-Indiana | Lead Clinical Performance, Value-Based Care & Strategic Health Syste
Indianapolis, IN · Remote
Lead initiatives focused on quality improvement, risk adjustment, care coordination, and utilization management. Health System & Community Partnership Development * Serve as the primary physician ...
Chief Medical Officer-Indiana | Lead Clinical Performance, Value-Based Care & Strategic Health Syste
Indianapolis, IN · Remote
Lead initiatives focused on quality improvement, risk adjustment, care coordination, and utilization management. Health System & Community Partnership Development * Serve as the primary physician ...
Utilization Management information
See Anderson, IN salary details
$33.8K - $43.6K
15% of jobs
$43.6K - $53.3K
8% of jobs
$54.7K is the 25th percentile. Wages below this are outliers.
$53.3K - $63.1K
15% of jobs
The median wage is $69.3K / yr.
$63.1K - $72.9K
20% of jobs
$72.9K - $82.6K
11% of jobs
$87.5K is the 75th percentile. Wages above this are outliers.
$82.6K - $92.4K
13% of jobs
$92.4K - $102.2K
5% of jobs
$102.2K - $111.9K
3% of jobs
$111.9K - $121.7K
4% of jobs
$121.7K - $131.5K
3% of jobs
$131.5K - $141.2K
3% of jobs
$33.8K
$77.5K
$141.2K
How much do utilization management jobs pay per year?
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 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 degree is needed for utilization management?
What are popular job titles related to Utilization Management jobs in Anderson, IN?
For Utilization Management jobs in Anderson, IN, the most frequently searched job titles are:
What job categories do people searching Utilization Management jobs in Anderson, IN look for?
The top searched job categories for Utilization Management jobs in Anderson, IN are:
What cities near Anderson, IN are hiring for Utilization Management jobs?
Cities near Anderson, IN with the most Utilization Management job openings:

Full-time
Posted 7 days ago
Franciscan Health rating
6.8
Based on 272 frontline employees who took The Breakroom Quiz
499th of 896 rated healthcare providers
Job description
The Supervisor Utilization Management is responsible for the direct supervision of the daily operations of the Centralized Utilization Management department in order to assure that utilization management needs are addressed. This position ensures appropriate staffing levels, ongoing educational opportunities, and employee satisfaction to maintain operational commitment. The Supervisor maintains and enhances relationships with internal and external customers and peers across the continuum in order to facilitate excellent outcomes for patients and Franciscan.
WHO WE ARE
With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.
WHAT YOU CAN EXPECT
Maintain inter- and intra-departmental communications, special projects, programs, policies, and procedures as well as care management services.
Participate and educate team in performance improvement initiatives. Implement processes to satisfaction with those we are privileged to serve.
Coordinate and maintain compliance with HFAP, state and federal agencies pertaining to Utilization/Denial management activities.
Supervise direct reports and manage the performance of individuals through ongoing coaching, feedback, and development to motivate, engage and drive a high performing team.
Make decisions for direct reports in assigned function and performs people management activities, such as, performance evaluations, disciplinary actions, staff planning, and interviews.
Supervise and maintain Utilization Management operations in collaboration with the Manager and Director, including ensuring appropriate utilization and denial management.
QUALIFICATIONS
Bachelor's Degree in Nursing required
Active Indiana Registered Nurse (RN) license required
5 years of Nursing/Patient Care required
2 years of Utilization or Case Management experience preferred
TRAVEL IS REQUIRED:
EQUAL OPPORTUNITY EMPLOYER
It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.
Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.
Franciscan Alliance is committed to equal employment opportunity.
Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on thebenefit section of our career site, jobs.franciscanhealth.org.
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