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 ...
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 ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
Quick apply
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
Case Manager
$19 - $24.50/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
$19 - $24.50/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
Newburgh, IN · On-site
$19 - $24.50/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
Newburgh, IN · On-site
$19 - $24.50/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
Newburgh, IN · On-site
$19 - $24.50/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
Case Manager
Newburgh, IN · On-site
$19 - $24.50/hr
Participate in utilization review process: data collection, trend review, and resolution actions. * Participate in case management on-call schedule as needed. Qualifications * License or ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
... thorough review of the total resources available to patient pre and post-discharge from ... Functions as liaison with payer representatives to manage the rehabilitation process in keeping ...
RN - Case Manager
$1K - $1K/wk
Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Indianapolis, Indiana Start Date: June 14, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...
RN - Case Manager
$1K - $1K/wk
Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Indianapolis, Indiana Start Date: June 14, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...
RN - Case Manager
$1K - $1K/wk
Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Evansville, Indiana Start Date: February 15, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1686 ...
RN - Case Manager
$1K - $1K/wk
Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Evansville, Indiana Start Date: February 15, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1686 ...
Nurse Case Manager I
Indianapolis, IN · On-site +1
JOB SUMMARY The Case Manager will evaluate medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation ...
Nurse Case Manager I
Indianapolis, IN · On-site +1
JOB SUMMARY The Case Manager will evaluate medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation ...
Nurse Case Manager I
Indianapolis, IN · On-site +1
JOB SUMMARY The Case Manager will evaluate medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation ...
Nurse Case Manager I
Indianapolis, IN · On-site +1
JOB SUMMARY The Case Manager will evaluate medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation ...
Case Manager II PRN
Indianapolis, IN · On-site
... case management ... utilization review and management, and discharge planning. Essential Functions Care Coordination
Case Manager II PRN
Indianapolis, IN · On-site
... case management ... utilization review and management, and discharge planning. Essential Functions Care Coordination
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
... utilization review and management and discharge planning. Has accountability for the care ... Certification in Case Management (CCM or ACMA) - (preferred). * Team building skills with the ...
... utilization review and management and discharge planning. Has accountability for the care ... Certification in Case Management (CCM or ACMA) - (preferred). * Team building skills with the ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
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 Jun 12, 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:
- Utilization Management
- Manager Utilization Management
- Temporary Admission Discharge Nurse
- Cvs Health Utilization Management
- Registered Nurse Utilization Review
- Interqual Training Operation
- No Experience Utilization Review Nurse
- Remote Utilization Management
- Telecommute Medical Record Reviewer
- 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
- Lpn Utilization Review Work From Home
- Weekend Utilization Review
- Director Optum Utilization Review
- Utilization Review Manager
- Remote Aetna Utilization Review Nurse
- Registered Nurse Reviewer
- Volunteer Aetna Utilization Review Nurse
- Registered Nurse Case Review
- Nurse Practitioner Utilization Review
What cities in Indiana are hiring for Utilization Review Case Manager jobs? Cities in Indiana with the most Utilization Review Case Manager job openings:
Job description
Company Description
Why You Should Work For Us:
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Description
- Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs, or community resources.
- Applies clinical knowledge to work with facilities and providers for care coordination.
- Works with medical directors in interpreting appropriateness of care and accurate claims payment.
- 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 applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Qualifications
- Must have clear and active RN license in the state of IN
- AS/BS in Nursing or combination of education / experience
- 2 years of experience in an acute care clinical environment
- Strong computer skills/ability to navigate multiple systems (MS Outlook/Word/Excel)
Additional Information
Advantages of this Opportunity:
- Competitive salary
- Fun and positive work environment
- Medical benefits offered
Interested in being considered?Â
Apply now for immediate consideration! You may contact Christine Morta at (407) 233-0769.
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003