ZipRecruiter

Log In

1

Utilization Manager Jobs in Lowell, IN (NOW HIRING)

Riverside Healthcare

PHYSICIAN ADVISOR

Kankakee, IL · On-site

$95.38/hr

The Physician Advisor provides expertise in medical necessity, documentation, care progression, and denial management, working closely with Care Management, Utilization Review, Revenue Cycle, and ...

Powers Health

Manager Sourcing

Munster, IN · On-site

$43.45 - $68.50/hr

The Manager of Sourcing develops sourcing strategies that align with organizational goals ... utilization review and spend analysis. * Provide category expertise and experience to support ...

Powers Health

Manager Sourcing

Munster, IN

The Manager of Sourcing develops sourcing strategies that align with organizational goals ... utilization review and spend analysis. * Provide category expertise and experience to support ...

Edgewater Health

Nurse Manager

Gary, IN

The Nurse Manager evaluates the health needs of clients, oversees medication management, develops ... Ensures standards for admission, utilization review, and concurrent review are followed. Staff ...

EDGEWATER HEALTH

NURSE MANAGER

Gary, IN · On-site

SUMMARY/OBJECTIVES The Nurse Manager provides clinical leadership, operational oversight, and ... Ensures standards for admission, utilization review, and concurrent review are followed. Staff ...

Sinai Health System

RN Case Manager

Hammond, IN · On-site

The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...

Sinai Health System

RN Case Manager

Calumet City, IL · On-site

The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...

Munster Med-Inn

Unit Manager

Munster, IN

$67K - $67K/yr

The Unit Manager - RN coordinates resource utilization, timely and appropriate care interventions, and interdisciplinary communication to enhance patient and family satisfaction, adherence to center ...

AFC Companies

Driver Manager

Gary, IN

$47K - $57K/yr

Monitor and coach driver performance to hit revenue, utilization, and safety goals * Partner with ... Experience in fleet management, driver management, or logistics operations * Strong communication ...

Crunch Fitness

General Manager

Schererville, IN · On-site

$60K/yr

Training & development General Manager | Fit Fusion Overview The general manager is responsible for ... Command of all offerings, amenities, and equipment utilization. * Ensure and monitor compliance and ...

previous pagenext page

Showing results 21-40

All JobsUtilization JobsUtilization Manager JobsUtilization Manager Jobs in Lowell, IN

Utilization Manager information

See Lowell, IN salary details

$37.3K

$87K

$160K

How much do utilization manager jobs pay per year?

As of Aug 12, 2026, the average yearly pay for utilization manager in Lowell, IN is $86,952.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,800.00 and $104,600.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a utilization manager?

To thrive as a Utilization Manager, you need a solid background in healthcare management, case review, and knowledge of insurance regulations, often supported by a degree in nursing, healthcare administration, or a related field. Familiarity with utilization management software, electronic health records (EHRs), and certification such as Certified Case Manager (CCM) are typically required. Strong analytical thinking, communication, and negotiation skills help Utilization Managers effectively coordinate care and collaborate with providers. These skills ensure appropriate resource use, regulatory compliance, and optimal patient outcomes within healthcare organizations.

What are some common challenges faced by utilization managers, and how can they be addressed?

Utilization Managers often face challenges such as balancing cost containment with patient care quality, navigating complex insurance policies, and managing high caseloads. To address these, effective communication with healthcare providers and payers is essential, as is staying current with regulatory requirements and best practices. Building strong relationships within interdisciplinary teams and leveraging data analytics tools can also help Utilization Managers make informed decisions and improve workflow efficiency.

What is a utilization manager?

A utilization manager works in the insurance industry to analyze health care needs in medical cases and determine further patient care. In this career, your job duties include conducting interviews to determine what services you register for and cutting down on unnecessary costs. You may review medical records and compile documentation to improve care and report your findings. Skills in management, customer service, and health care services are vital in this career. Job experience in nursing is a benefit when applying for utilization manager positions. Additional qualifications include a bachelor’s degree and medical case management certificate.

What is the difference between Utilization Manager vs Utilization Coordinator?

AspectUtilization ManagerUtilization Coordinator
CertificationsOften requires healthcare or case management certificationsMay have similar certifications but less emphasis on management
Work EnvironmentTypically in healthcare organizations, overseeing utilization review processesSupports daily operations, assisting with case documentation and scheduling
Employer & Industry UsageCommon in healthcare, insurance, and managed care companiesFound in similar settings, often working under Utilization Managers

In summary, a Utilization Manager generally has broader responsibilities, overseeing utilization review and resource allocation, while a Utilization Coordinator focuses on supporting daily tasks and documentation. Both roles are integral in healthcare settings but differ in scope and level of responsibility.

More about Utilization Manager jobs
What are the most commonly searched types of Utilization jobs in Lowell, IN? The most popular types of Utilization jobs in Lowell, IN are:
What cities near Lowell, IN are hiring for Utilization Manager jobs? Cities near Lowell, IN with the most Utilization Manager job openings:
Utilization Manager jobs near you
Infographic showing various Utilization Manager job openings in Lowell, IN as of August 2026, with employment types broken down into 100% Full Time. Highlights an 80% In-person, and 20% Remote job distribution, with an average salary of $86,952 per year, or $41.8 per hour.

PHYSICIAN ADVISOR

Riverside Healthcare

Kankakee, IL • On-site

$95.38/hr

Full-time

Re-posted 11 days ago

Job description

Overview
We are seeking a detail oriented Physician Advisor to join our inpatient team full time. This role serves as a key clinical and operational leader, supporting effective utilization of healthcare services and ensuring compliance with payer and regulatory requirements. The Physician Advisor provides expertise in medical necessity, documentation, care progression, and denial management, working closely with Care Management, Utilization Review, Revenue Cycle, and hospital leadership. This position reflects rotating weekend call coverage.
Reporting to the Chief Medical Officer the Physician Advisor partners with medical staff leadership, providers, and resource management teams to optimize utilization practices and support organizational goals.
Essential Duties:
  • Make recommendations on level of care including initial level of care, secondary review, and as requested by case management
  • Make recommendations for documentation improvement to ensure the medical record accurately reflects the patient's clinical status, supports the level of care provided, and meets regulatory and payer requirements.
  • Collaborate with providers to identify opportunities for enhanced documentation that clarifies the rationale for services rendered, severity of illness, and care progression, thereby reducing the risk of denials and facilitating appropriate reimbursement.
  • Make recommendations on level of care, including initial level of care, secondary review, and as requested by case management.
  • Make recommendations for documentation improvement to ensure the medical record accurately reflects the patient's clinical status, supports the level of care provided, and meets regulatory and payer requirements.
  • Review for daily level of care recommendations on cases placed in Observation
  • Participate in the denials management process
  • Be a leader in optimizing denial management
  • Perform peer to peer appeals and draft appeal letters for third party denials where appropriate
  • Apply the 2 midnight rule to Medicare reviews
  • Maintain compliance with Medicare rules as it applies to level of care recommendations
  • Stay current on changes in payer rules including CMS rules as it pertains to utilization review
  • Recommend and request additional and more complete medical record documentation from providers to support placement status or medical necessity
  • Understand and use InterQual, MCG and/or other appropriate criteria
  • Apply medical expertise to assist with appropriate billing for services
  • Provide feedback on payer denial patterns where appropriate
  • Aid in supporting Length of Stay (LOS) strategies (avoidable days) and quality goals.
  • Facilitate, mentor, and educate other physicians regarding documentation and payer requirements.
  • Facilitate, mentor, and educate case management on the utilization review process where appropriate
  • Other duties as assigned to support the unit, department, entity, and health system organization

Responsibilities
Required Education/Licensure:
  • MD or DO
  • Possess and maintain an unrestricted medical license in the State of Illinois

Required Experience:
  • Minimum 5 years clinical experience in a hospital setting
  • Possess or develop a solid foundation in the areas of utilization management and hospital operations

Preferred Education/Licensure:
  • Palliative Care Fellowship
  • American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) Health Care Quality and Management (HCQM) certification
  • American College of Physician Advisors certification (ACPA-C)

Location:
Riverside Medical Group
350 N. Wall St. Kankakee, IL
Employee Health Requirements:
Exposure to:
Chemicals: Refer to MSDS Sheets
Video Display Terminals: Average
Blood and Body Fluids: None
TB or Airborne Pathogens: None other than normal hospital environment exposure.
Sensory requirements (speech, vision, smell, hearing, touch):
Speech: Required to communicate during presentations/training, telephone communication, facilitate meetings, communication with providers and other staff.
Vision: Needed to read memos and literature, type correspondence from handwritten material and to coordinate calendars.
Smell: Helpful to note presence of electrical/fire safety.
Hearing: Needed for telephone communication, meetings, alarms and listening to employees/staff.
Touch: Needed to write, computer entry, filing.
Activity/Lifting Requirements
Percentage of time during the normal workday the employee is required to:
Sit: 70%
Twist: 0%
Stand: 10%
Crawl: 0%
Walk: 15%
Kneel: 1%
Lift: 5%
Drive: 0%
Squat: 5%
Climb: 1%
Bend: 5%
Reach above shoulders: 0%
The weight required to be lifted each normal workday according to the continuum described below:
Up to 10 lbs: Occasionally
Up to 20 lbs: Occasionally
Up to 35 lbs: Occasionally
Up to 50 lbs:Not Required
Up to 75 lbs: Not Required
Up to 100 lbs: Not Required
Over 100 lbs: Not Required
Describe and explain the lifting and carrying requirements. (Example: the distance material is carried; how high material is lifted, etc.):
Maximum consecutive time (minutes) during the normal workday for each activity:
Sit: 120
Twist: 0
Stand: 30
Crawl: 0
Walk: 5
Kneel: 2
Lift: 1
Drive: 0
Squat: 5
Climb: 0
Bend: 5
Reach above shoulders: 2
Repetitive use of hands (Frequency indicated):
Simple grasp up to 1 lbs. Normal weight: frequent
Pushing & pulling Normal weight: 5lbs frequent
Fine Manipulation: Moving charts, written documentation.
Repetitive use of foot or feet in operating machine control: None
Environmental Factors & Special Hazards
Environmental Factors (Time Spent):
Inside hours: 8
Outside hours : 0
Temperature: Normal Range
Lighting: Average
Noise levels: Average
Humidity: Normal Range
Atmosphere: Normal Range
Special Hazards: None
Protective Clothing Required: None
Pay Range
USD $95.38 - USD $141.06 /Hr

Apply