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Utilization Management Jobs in Fort Wayne, IN (NOW HIRING)

Pharmacy Careers

Appeals Pharmacist (Remote)

Fort Wayne, IN · On-site

$52.25 - $63.75/hr

Experience: Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists with strong documentation and clinical skills are encouraged to apply. * Skills:

Acadia Healthcare

Utilization Assistant

Fort Wayne, IN · On-site

Provide administrative support to the Utilization department. Responsibilities ESSENTIAL FUNCTIONS ... Gather data to support case management activities, including presentation of gathered data and case ...

Acadia Healthcare

Utilization Assistant

Fort Wayne, IN · On-site

PURPOSE STATEMENT: Provide administrative support to the Utilization department. ESSENTIAL ... Gather data to support case management activities, including presentation of gathered data and case ...

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All JobsUtilization Management JobsUtilization Management Jobs in Fort Wayne, IN

Utilization Management information

See Fort Wayne, IN salary details

$38.5K

$88.3K

$160.8K

How much do utilization management jobs pay per year?

As of Sep 2, 2026, the average yearly pay for utilization management in Fort Wayne, IN is $88,288.00, according to ZipRecruiter salary data. Most workers in this role earn between $63,600.00 and $103,100.00 per year, depending on experience, location, and employer.

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?

Utilization management professionals typically need at least a bachelor's degree in healthcare, nursing, health administration, or a related field. Some roles may require a master's degree or professional certifications such as Certified Professional in Healthcare Quality (CPHQ) or Certified Case Manager (CCM). Experience in healthcare settings and knowledge of medical terminology and insurance processes are also important.

What are the most commonly searched types of Utilization Management jobs in Fort Wayne, IN?

The most popular types of Utilization Management jobs in Fort Wayne, IN are:

What are popular job titles related to Utilization Management jobs in Fort Wayne, IN?

For Utilization Management jobs in Fort Wayne, IN, the most frequently searched job titles are:

What job categories do people searching Utilization Management jobs in Fort Wayne, IN look for?

The top searched job categories for Utilization Management jobs in Fort Wayne, IN are:

What cities near Fort Wayne, IN are hiring for Utilization Management jobs?

Cities near Fort Wayne, IN with the most Utilization Management job openings:

Utilization Management jobs near you
Infographic showing various Utilization Management job openings in Fort Wayne, IN as of August 2026, with employment types broken down into 92% Full Time, and 8% Part Time. Highlights an 92% In-person, 3% Hybrid, and 5% Remote job distribution, with an average salary of $88,288 per year, or $42.4 per hour.

Appeals Pharmacist (Remote)

Pharmacy Careers

Fort Wayne, IN • On-site

$52.25 - $63.75/hr

Other

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

Remote Appeals Pharmacist – Fair Medication Access

Work From Home | Strong Clinical Writing Focus Combine clinical expertise with advocacy in a fully remote Appeals Pharmacist role. Review medication coverage appeals, apply evidence-based guidelines, and ensure fair determinations for members — all from home with a schedule that supports better work-life balance.

Key Responsibilities

  • Review clinical documentation for medication coverage appeals and grievances.
  • Apply plan policies, evidence-based guidelines, and regulatory requirements to reach determinations.
  • Prepare clear written clinical rationales supporting appeal outcomes.
  • Collaborate with physicians, nurses, and medical directors during case reviews.
  • Track and report appeal outcomes in full compliance with state and federal rules.
  • Contribute to process improvements that enhance timeliness and quality.

What You'll Bring

  • Education: PharmD or Bachelor of Pharmacy.
  • Licensure: Active U.S. pharmacist license.
  • Experience: Managed care or utilization management preferred. Hospital, ambulatory, and community pharmacists with strong documentation and clinical skills are encouraged to apply.
  • Skills: Excellent clinical judgment, written communication, and regulatory attention to detail.

Why This Role?

  • Fully remote or hybrid options available.
  • Play a critical role in ensuring patients receive fair access to necessary medications.
  • Build expertise in appeals, utilization management, and managed care.
  • Competitive salary, comprehensive benefits, and advancement paths.

About Us We are a confidential healthcare partner working with health plans and managed-care organizations nationwide. Our appeals pharmacists protect patient access while upholding regulatory standards. Apply Today Join our team as a Remote Appeals Pharmacist and help ensure every member receives a fair, evidence-based review.

Apply