ZipRecruiter

Log In

1

Utilization Review Case Manager Jobs in Indiana (NOW HIRING)

Socket.dev

Utilization Review Manager

Lafayette, IN · On-site

From your first day to your next career milestone--your experience matters How you'll contribute The responsibility of the UR Manager is to ensure the utilization review activities are completed ...

Seven Healthcare

RN - Case Management

Fort Wayne, IN · On-site

$2.7K/wk

This role focuses on inpatient case management within an acute care setting, emphasizing utilization review and comprehensive discharge planning. The selected candidate will work collaboratively ...

previous pagenext page

Showing results 21-40

All JobsUtilization Review Case JobsUtilization Review Case Manager JobsUtilization Review Case Manager Jobs in Indiana

Utilization Review Case Manager information

See Indiana salary details

$15

$34

$57

How much do utilization review case manager jobs pay per hour?

As of Sep 15, 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 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 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 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 is the difference between Utilization Review Case Manager vs Utilization Review Nurse?

AspectUtilization Review Case ManagerUtilization Review Nurse
CredentialsTypically requires a nursing license or relevant healthcare certificationRegistered Nurse (RN) license is required
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinic, insurance review departments
Primary FocusReviewing medical necessity, coordinating care, managing casesAssessing 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 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:

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:

What cities in Indiana are hiring for Utilization Review Case Manager jobs?

Cities in Indiana with the most Utilization Review Case Manager job openings:

Utilization Review Case Manager jobs near you
Infographic showing various Utilization Review Case Manager job openings in Indiana as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 13% Part Time, and 2% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $72,215 per year, or $34.7 per hour.

UTILIZATION REVIEW NURSE RN

Indianapolis, IN • On-site

Health & Hospital Corporation of Marion County
Health Care and Social Assistance • 1 - 5K employees
Learn more about Health & Hospital Corporation of Marion Countyexternal

Other

Posted 6 days ago

Job description

Division:Eskenazi Health
Sub-Division: Hospital
Req ID: 26738
Schedule: Full Time
Shift: Days
Salary Range:
Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 327-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus as well as at 10 Eskenazi Health Center sites located throughout Indianapolis.
FLSA Status
Exempt
#EXPRN
Job Role Summary
The Utilization Review Nurse works behind the scenes to maximize the quality and cost efficiency of health care services. Through regular reviews and audits, ensures that patients receive the care they need without burdening the health care system with unnecessary procedures, ineffective treatments or overlong hospital stays. This position is responsible for ensuring the provision of quality patient care, effective utilization of available health services, review of medical necessity of admissions, and necessity for continued stay in hospital; analyzes patient records to ensure compliance with government and insurance company reimbursement policies and accrediting standards.
Essential Functions and Responsibilities
  • Work behind the scenes to maximize the quality and cost efficiency of health care services. Through regular reviews and audits, ensure that patients receive the care they need without burdening the health care system with unnecessary procedures, ineffective treatments or overlong hospital stays
  • Communicates secondary review decisions determining appropriate patient status provided by secondary reviewer process
  • Ensuring the provision of quality patient care, effective utilization of available health services, review of medical necessity of admissions, and necessity for continued stay in hospital; analyzes patient records to ensure compliance with government and insurance company reimbursement policies and accrediting standards
  • Responsible for managing each patient's plan of care, monitoring for appropriate resource utilization, and collaborating with the inpatient team as well as outpatient providers to coordinate the patient's transition plan of care
  • Serves as a patient advocate, ensuring that efficient health care is provided. The role is to provide primary nurse support through all aspects of utilization management across the continuum of care and is not limited to the initial review process
  • Assesses degree of medical necessity for any patient seen in the Emergency Department and perform Utilization Review using the Eskenazi Health approved clinical decision support criteria
  • Reviews patients' admissions for appropriateness and type. Refers case to Medical Director and/or Department leadership for review when case fails to meet admission standards
  • Coordinates the most accurate and appropriate patient status for care
  • Identifies strategies to reduce the length of stay and resource consumption within the appropriate length of stay
  • Assesses patient's health status through collection of information from EMR, interview any other relevant sources to collect specific information in an attempt to provide the necessary determination for patient's status for appropriate medical regimen
  • Track readmissions and Emergency Department visits for patients assigned
  • Completes an admission review even when the patient under assessment has been relocated to an admitted or observation bed
  • Collaborates with Emergency Physicians and Attending Physicians to ensure that patients meet criteria for Admission, Placement on Observation Status or neither
  • Oversees the initial admission review, utilizing criteria, within 24-48 hours of the patient's admission to the hospital to ensure appropriateness of the assigned level of care and timely implementation of the treatment plan
  • Applies appropriate clinical criteria to complete initial reviews within 24-48 hours of patient presentation
  • Communicate with the Inpatient Case Manager to ensure appropriate status and level of care for patient, and that transition plan is implemented with determined goals in mind
  • Communicates with Payor Specialist for UR/UM to ensure proper status change and accurate billing practices
  • Evaluatesthe active funding for each patient and communicates with Inpatient Case Manager/Social Worker to facilitate initiation of appropriate funding applications
  • Demonstrates knowledge of levels of care of Inpatient and Outpatient status
  • Ensures that transitions to post-acute services such as Acute Rehabilitation Centers is appropriate and streamlined, and home care services, as well as durable medical equipment is appropriately utilized
  • Ensure the need for any services not provided at Eskenazi Health is evaluated and appropriate authorization is given and documented
Job Requirements
  • Current Indiana nursing license required
  • Minimum of 4 years clinical nursing experience required
Knowledge, Skills & Abilities
  • Must demonstrate knowledge of the Utilization Management managed care processes
  • Competency in the following areas required:
    • interpersonal, written/verbal communication, and negotiation skills
    • diplomacy, flexibility, and professionalism
    • cohesive networking with the Interdisciplinary Team

Accredited by The Joint Commission and named one of the nation's 150 best places to work by Becker's Hospital Review for four consecutive years and Forbes list of best places to work for women, and Forbes list of America's best midsize employers' Eskenazi Health's programs have received national recognition while also offering new health care opportunities to the local community. As the sponsoring hospital for Indianapolis Emergency Medical Services, the city's primary EMS provider, Eskenazi Health is also home to the first adult Level I trauma center in Indiana, the first verified adult burn center in Indiana, the first community mental health center in Indiana and the Eskenazi Health Center Primary Care - Center of Excellence in Women's Health, just to name a few.

Apply