Responsibilities The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements ...
Responsibilities The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements ...
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 ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...
Reviews application for client admission and approves admission or refers case to utilization review committee for review and course of action when case fails to meet admission standards. • Manages ...
Reviews application for client admission and approves admission or refers case to utilization review committee for review and course of action when case fails to meet admission standards. • Manages ...
... 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 ...
... 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 ...
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
... 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 ...
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
UR contacts external case managers/managed care organizations for certification of insurance ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
... 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 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 ...
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 ...
Clinical Case Mgr
Noblesville, IN · On-site
Job Summary The Case Manager is responsible for coordinating all aspects of patient ... Performs utilization reviews, review medical records and coordinates with various payers to ensure ...
Clinical Case Mgr
Noblesville, IN · On-site
Job Summary The Case Manager is responsible for coordinating all aspects of patient ... Performs utilization reviews, review medical records and coordinates with various payers to ensure ...
Utilization Review RN
$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
$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 ...
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 ...
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 ...
Clinical Case Mgr
Noblesville, IN · On-site
Job Summary The Case Manager is responsible for coordinating all aspects of patient ... Performs utilization reviews, review medical records and coordinates with various payers to ensure ...
Clinical Case Mgr
Noblesville, IN · On-site
Job Summary The Case Manager is responsible for coordinating all aspects of patient ... Performs utilization reviews, review medical records and coordinates with various payers to ensure ...
Utilization Review Case Manager information
See Indiana salary details
$15.78 - $19.55
3% of jobs
$19.55 - $23.31
1% of jobs
$23.31 - $27.07
6% of jobs
$28.89 is the 25th percentile. Wages below this are outliers.
$27.07 - $30.84
30% of jobs
The median wage is $32.19 / hr.
$30.84 - $34.60
26% of jobs
$36.04 is the 75th percentile. Wages above this are outliers.
$34.60 - $38.37
22% of jobs
$38.37 - $42.13
3% of jobs
$42.13 - $45.89
0% of jobs
$45.89 - $49.66
5% of jobs
$49.66 - $53.42
2% of jobs
$53.42 - $57.19
1% of jobs
$15
$34
$57
How much do utilization review case manager jobs pay per hour?
As of Aug 4, 2026, the average hourly pay for utilization review case manager in Indiana is $34.72, according to ZipRecruiter salary data. Most workers in this role earn between $28.12 and $36.59 per hour, depending on experience, location, and employer.
What are some common challenges utilization review case managers face when coordinating care across multiple departments?
Utilization Review Case Managers often navigate complex communication between physicians, nursing staff, insurance providers, and patients to ensure appropriate care and resource use. Balancing timely authorizations with evolving patient needs and varying documentation standards can be challenging. Additionally, staying current with changing regulations and payer requirements requires ongoing learning and adaptability. Building strong collaborative relationships and maintaining clear, concise documentation are key strategies for overcoming these hurdles.
What is a utilization review case manager?
A Utilization Review Case Manager is a healthcare professional responsible for evaluating the necessity, appropriateness, and efficiency of medical treatments and services provided to patients. They review clinical information, coordinate with providers and insurance companies, and ensure that patient care aligns with established guidelines and policies. Their goal is to optimize patient outcomes while managing healthcare costs and ensuring compliance with regulations.
What is the difference between Utilization Review Case Manager vs Utilization Review Nurse?
| Aspect | Utilization Review Case Manager | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license or relevant healthcare certification | Registered Nurse (RN) license is required |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinic, insurance review departments |
| Primary Focus | Reviewing medical necessity, coordinating care, managing cases | Assessing medical records, clinical review, patient care evaluation |
Both roles involve healthcare review and require nursing credentials, but the Utilization Review Case Manager often focuses on coordinating care and managing cases, while the Utilization Review Nurse emphasizes clinical assessment and review of medical records. Understanding these differences helps in choosing the right career path or job search focus.
What are the key skills and qualifications needed to thrive as a utilization review case manager, and why are they important?
To thrive as a Utilization Review Case Manager, you need a clinical background such as an RN or LCSW license, strong knowledge of medical necessity criteria, and experience with case management. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like Medicare and Medicaid are essential. Excellent communication, critical thinking, and negotiation skills help facilitate collaboration between patients, providers, and payers. These skills ensure appropriate resource use, compliance with regulations, and high-quality patient care.
What are popular job titles related to Utilization Review Case Manager jobs in Indiana? For Utilization Review Case Manager jobs in Indiana, the most frequently searched job titles are:
- Flex Schedule Remote Utilization Review Nurse
- No Experience Utilization Review Nurse
- Weekend Prior Authorization Nurse
- Utilization Management
- Cvs Health Utilization Management
- Registered Nurse Utilization Review
- Remote Cvs Utilization Management Nurse
- Temporary Admission Discharge Nurse
- Remote Utilization Management
- Commission Cvs Health Utilization Management
What job categories do people searching Utilization Review Case Manager jobs in Indiana look for? The top searched job categories for Utilization Review Case Manager jobs in Indiana are:
- Foster Care Case Manager
- Freelance International Utilization Review Nurse
- Lpn Utilization Review Nurse
- Remote Hca Utilization Review
- Remote Insurance Utilization Review
- Nurse Case Manager Work From Home
- Field Nurse Case Manager
- Chart Utilization Review
- Temporary Aetna Utilization Review Nurse
- From Home Anthem Utilization Review Nurse
What cities in Indiana are hiring for Utilization Review Case Manager jobs? Cities in Indiana with the most Utilization Review Case Manager job openings:
Universal Health Services rating
6.8
Based on 253 frontline employees who took The Breakroom Quiz
493rd of 887 rated healthcare providers
Job description
Responsibilities
The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.
Qualifications
QUALIFICATIONS
Education :Must have Registered Nurse license or Master's Degree.
Experience: 5-7 yrs acute inpatient psychiatric setting as a treatment team member experience or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders experience.
Work Location: In person
The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department administration. Supports the overall success of the hospital and promotes patient satisfaction, regulatory compliance and optimal reimbursement.
Qualifications
QUALIFICATIONS
Education :Must have Registered Nurse license or Master's Degree.
Experience: 5-7 yrs acute inpatient psychiatric setting as a treatment team member experience or 3-5 years of experience in utilization management for both mental health and substance abuse behavioral health disorders experience.
Work Location: In person
What Universal Health Services employees say
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About Universal Health Services
Sourced by ZipRecruiter
Universal Health Services (UHS) is a major player in the healthcare industry, based in King of Prussia, Pennsylvania, U.S. Founded in 1978, UHS offers hospital and healthcare services. Their diverse services range from acute care hospitals, behavioral health facilities and ambulatory centers nationwide. The company's mission of enhancing the health and well-being of their patients is reflected in their commitment to 'Helping Individuals Live Longer, Healthier and Happier Lives'. Universal Health Services' consistent growth and success in their industry have been recognized on numerous occasions, including being ranked amongst the Fortune 500 list of largest companies.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
King of Prussia, PA, US