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Utilization Management Jobs in Crown Point, IN (NOW HIRING)

Med-Metrix

Physician Advisor - Remote

Chicago, IL · On-site +1

Provides consultation to attendings, nurses, and case management staff regarding complex clinical issues and advises on justification required for continued stay, medical necessity and utilization ...

219 Health Network

Physician Advisor

Hobart, IN · On-site

Mary Medical Center - Hobart, IN 46342 The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key ...

Powers Health

Physician Advisor

Hobart, IN

The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical ...

Powers Health

Physician Advisor

Hobart, 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 ...

219 Health Network

Physician Advisor

Munster, IN · On-site

Community Hospital - Munster, IN 46321 The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key ...

Powers Health

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 ...

Powers Health

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 ...

Powers Health

Physician Advisor

Hobart, 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 ...

Powers Health

Physician Advisor

Munster, IN

The Physician Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical ...

Powers Health

Provider Advisor

Hobart, IN · On-site

$52.89 - $78.85/hr

The Provider Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical ...

Powers Health

Provider Advisor

Hobart, IN

The Provider Advisor will provide clinical expertise to support utilization management (UM) and quality initiatives within the healthcare setting. Key responsibilities include conducting clinical ...

Veracity

UR Review Case Manager (Admin)

Chicago, IL · On-site

... utilization management activities as determined by the utilization plan, professional standards and requirements of payers: • Works collaboratively with physicians and other healthcare team members ...

Advocate Health

Inpatient Care Manager

Chicago, IL · On-site

Ability to apply elements of Utilization Management programs. Physical REQUIREMENTS Must be able to sit up to approximately 50 percent of the workday; stand and walk for the equivalent of several ...

Powers Health

U.M. Tech

Munster, IN · On-site

$37K - $47K/yr

POSITION PURPOSE AND SUMMARY Utilization Management Technician communicates admission and concurrent reviews for certification and length of stay assignments to payers by fax, electronic, or ...

219 Health Network

U.M. Tech

Munster, IN · On-site

$37K - $47K/yr

Position Purpose And Summary Utilization Management Technician communicates admission and concurrent reviews for certification and length of stay assignments to payers by fax, electronic, or ...

New

Powers Health

U.M. Tech

Munster, IN

$37K - $47K/yr

POSITION PURPOSE AND SUMMARY Utilization Management Technician communicates admission and concurrent reviews for certification and length of stay assignments to payers by fax, electronic, or ...

Powers Health

U.M. Tech

Munster, IN · On-site

$18.97 - $30.92/hr

POSITION PURPOSE AND SUMMARY Utilization Management Technician communicates admission and concurrent reviews for certification and length of stay assignments to payers by fax, electronic, or ...

Advocate Aurora Health

ED Care Manager

Oak Lawn, IL · On-site

$38.20 - $57.30/hr

Ability to apply elements of Utilization Management programs. PHYSICAL REQUIREMENTS AND WORKING CONDITIONS * Must be able to alternate between sitting and standing intermittently throughout the ...

Advocate Aurora Health

Inpatient Care Manager

Chicago, IL · On-site

$38.20 - $57.30/hr

Ability to apply elements of Utilization Management programs. Physical REQUIREMENTS Must be able to sit up to approximately 50 percent of the workday; stand and walk for the equivalent of several ...

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Showing results 21-40

All JobsUtilization Management JobsUtilization Management Jobs in Crown Point, IN

Utilization Management information

See Crown Point, IN salary details

$37K

$84.9K

$154.7K

How much do utilization management jobs pay per year?

As of Aug 14, 2026, the average yearly pay for utilization management in Crown Point, IN is $84,905.00, according to ZipRecruiter salary data. Most workers in this role earn between $61,200.00 and $99,200.00 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 popular job titles related to Utilization Management jobs in Crown Point, IN?

For Utilization Management jobs in Crown Point, IN, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Crown Point, IN look for?

The top searched job categories for Utilization Management jobs in Crown Point, IN are:

What cities near Crown Point, IN are hiring for Utilization Management jobs?

Cities near Crown Point, IN with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Crown Point, IN as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 19% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution, with an average salary of $84,905 per year, or $40.8 per hour.

Physician Advisor - Remote

Med-Metrix

Chicago, IL • On-site, Remote

Contractor

Re-posted 18 days ago

Med-Metrix rating

6.9

Company rating: 6.9 out of 10

Based on 21 frontline employees who took The Breakroom Quiz

283rd of 491 rated business services

Job description

Job Purpose
The Physician Advisor performs case reviews of all case types in a knowledgeable and conscientious manner to achieve the highest degree of compliance. The Physician Advisor works closely with the Client's medical staff leadership, the entire medical staff, including resident physician house staff, all areas of resource management, case management, social services, discharge planning, and utilization management to recommend methods to optimize use of hospital services for all patients. This includes identifying opportunities to optimize length of hospital stay and efficient management of resources, ensuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance, and monitoring the appropriate use of diagnostic and therapeutic modalities.
Duties and Responsibilities
  • Responds to requests for assistance on clinical reviews for medical necessity or any other reason, by any member of the Case Management department in a timely fashion
  • Provides consultation to attendings, nurses, and case management staff regarding complex clinical issues and advises on justification required for continued stay, medical necessity and utilization management
  • Obtains familiarity and working knowledge of standard published criteria such as MCG/InterQual and applies professional judgment and patient specific variables as may be necessary or justifiable
  • Maintains accountability for achieving case management outcomes and fulfills the obligations and responsibilities of the role to support the medical staff in the clinical progression of patient care
  • Describes ways to provide improved health record documentation that specifically affect ICD code assignment capture of severity, acuity, risk of mortality, and DRG assignment
  • Participates in ongoing training and education related to the Physician Advisor role and responsibilities including topics related to Utilization Management, Care Management and other related areas as requested
  • Meets productivity and quality standards within established time requirements. Work product and performance meets or exceeds quality standards.
  • Achieve performance goals as outlined in employment agreement
  • Maintains confidentiality of patient care and business matters
  • Demonstrates behavior that supports the organization's mission. Participates in required orientation and training related to the Physician Advisor role
  • Demonstrates commitment to meeting/exceeding strategic initiatives of organization
  • Upholds the organization's values of teamwork and professionalism and applies Code of Conduct standards to all members of the healthcare team
  • Facilitate, mentor, and educate other physicians regarding payer requirements
  • Attends all meetings as requested by PAOC leadership
  • Participate in the peer review process as may be necessary or requested
  • Maintain medical licensure and board certification in good standing
  • During scheduled work hours, commits full attention to Physician Advisory and execution of outlined tasks
  • Other duties as assigned
  • Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
  • Understand and comply with Information Security and HIPAA policies and procedures at all times
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications
  • Board Certified and licensed to practice medicine in the US or 3+ years active clinical experience in the US
  • 3+ years working as a Physician Advisor performing Level of care reviews as well as Peer to Peer Reviews
  • Basic technical skills with Hospital EMRs a must
  • Hold and maintain an unrestricted medical license and Board Certification
  • Possess or acquires a solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety
  • Possess a working knowledge of (Hospital) organization & case management operations and administrative standards and policies
  • Familiarity with MCG/InterQual placement status criteria is preferred
  • Member of the American College of Physician Advisors (ACPA) preferred
  • Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred
  • Physician Advisor Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred
  • Able to effectively present information, both formal and informal
  • Strong analytical skills
  • Proficiency in Microsoft Office Suite
  • Strong interpersonal skills, ability to communicate well at all levels of the organization
  • Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
  • High level of integrity and dependability with a strong sense of urgency and results oriented
  • Excellent written and verbal communication skills required

Working Conditions
  • This role requires availability to provide a minimum of 16 shifts per month. Each shift is 6-8 hours in duration and includes 2 weekend shifts per month.
  • Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
  • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

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