... Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department ...
... Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements, staff management and department ...
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
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What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
What You Will Do As the Utilization Review Specialist, you will be responsible for managing prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications.
... 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:
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
UTILIZATION REVIEW RN
Seymour, IN · On-site
Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management
Overview NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Overview NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Registered Nurse Utilization Review
Carmel, IN · On-site +1
$50 - $52/hr
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and ... Review admissions and service requests within assigned unit for prospective, concurrent and ...
Registered Nurse Utilization Review
Carmel, IN · On-site +1
$50 - $52/hr
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and ... Review admissions and service requests within assigned unit for prospective, concurrent and ...
Overview NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Overview NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review ... 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 ...
NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review Coordinator to ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
NeuroPsychiatric Hospital of Indianapolis is looking for a PRN Utilization Review Coordinator to ... Minimum of 2 years of case management experience, including discharge planning in a hospital ...
Registered Nurse Utilization Review
Carmel, IN · On-site
$84K/yr
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and ... Review admissions and service requests within assigned unit for prospective, concurrent and ...
Registered Nurse Utilization Review
Carmel, IN · On-site
$84K/yr
Utilization Management Schedule: PRN. 0800-1700 ET, need coverage for Monday-Friday, weekends and ... Review admissions and service requests within assigned unit for prospective, concurrent and ...
Prior experience in utilization review, case management, discharge planning, prospective payment systems (DRGs), or the CMS Medicare Swing Bed Program. Mental/Physical Effort: Work 90% of the time in ...
Prior experience in utilization review, case management, discharge planning, prospective payment systems (DRGs), or the CMS Medicare Swing Bed Program. Mental/Physical Effort: Work 90% of the time in ...
Prior experience in utilization review, case management, discharge planning, prospective payment systems (DRGs), or the CMS Medicare Swing Bed Program. Mental/Physical Effort: Work 90% of the time in ...
Prior experience in utilization review, case management, discharge planning, prospective payment systems (DRGs), or the CMS Medicare Swing Bed Program. Mental/Physical Effort: Work 90% of the time in ...
... 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 ...
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 ...
Utilization Review Manager information
See Indiana salary details
$37.1K - $48.2K
9% of jobs
$56.4K is the 25th percentile. Wages below this are outliers.
$48.2K - $59.3K
22% of jobs
$59.3K - $70.5K
11% of jobs
The median wage is $77.3K / yr.
$70.5K - $81.6K
14% of jobs
$81.6K - $92.7K
12% of jobs
$99.6K is the 75th percentile. Wages above this are outliers.
$92.7K - $103.8K
13% of jobs
$103.8K - $114.9K
13% of jobs
$114.9K - $126K
5% of jobs
$126K - $137.2K
2% of jobs
$137.2K - $148.3K
0% of jobs
$148.3K - $159.4K
0% of jobs
$37.1K
$86.6K
$159.4K
How much do utilization review manager jobs pay per year?
As of Sep 1, 2026, the average yearly pay for utilization review manager in Indiana is $86,603.00, according to ZipRecruiter salary data. Most workers in this role earn between $56,600.00 and $104,200.00 per year, depending on experience, location, and employer.
What does a utilization review manager do?
A Utilization Review Manager oversees the process of evaluating the necessity, appropriateness, and efficiency of healthcare services provided to patients. They ensure that patient care adheres to established guidelines and that healthcare resources are used effectively. Their duties typically include leading a team of reviewers, collaborating with healthcare providers, ensuring compliance with regulations, and making recommendations on care authorization. The goal is to balance quality patient care with cost-effective resource management.
What are the key skills and qualifications needed to thrive as a utilization review manager?
To thrive as a Utilization Review Manager, you need a solid background in healthcare management, clinical knowledge (often as an RN or healthcare professional), and experience with utilization review processes. Familiarity with case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Certified Professional in Utilization Review (CPUR) are often expected. Strong analytical thinking, attention to detail, leadership, and effective communication are crucial soft skills for success in this role. These skills ensure appropriate resource use, regulatory compliance, and coordinated patient care, which are vital for both healthcare quality and operational efficiency.
What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?
Utilization Review Managers often encounter the challenge of ensuring patients receive appropriate care while also adhering to insurance and regulatory guidelines that emphasize cost efficiency. This requires strong analytical skills to assess clinical information and make fair determinations, often under tight deadlines and with incomplete data. The role also involves frequent communication with physicians, payers, and case managers to resolve disagreements and clarify criteria, making negotiation and diplomacy essential. Staying updated on changing healthcare regulations and payer requirements can add to the complexity, but it also provides opportunities for professional growth and leadership within healthcare administration.
What is the difference between Utilization Review Manager vs Utilization Review Coordinator?
| Aspect | Utilization Review Manager | Utilization Review Coordinator |
|---|---|---|
| Certifications | Typically requires certifications like CCM or ACU | May require similar certifications but often less advanced |
| Work Environment | Supervises review teams, manages processes in healthcare or insurance settings | Performs case reviews, supports the review process under supervision |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Insurance companies, healthcare providers, third-party administrators |
The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.
How much does a utilization review manager make?
A utilization review manager typically earns between $70,000 and $110,000 annually, depending on experience, location, and the size of the organization. They often require knowledge of healthcare policies, insurance processes, and may hold certifications such as URAC or CCM.
Is utilization review manager a stressful job?
Utilization review managers often work in a fast-paced healthcare environment, which can be stressful due to the need to meet strict deadlines, ensure accurate assessments, and handle complex cases. The role requires strong organizational skills and attention to detail, and some individuals may find the responsibility and workload challenging, especially during high-volume periods.
What are the most commonly searched types of Utilization Review jobs in Indiana?
The most popular types of Utilization Review jobs in Indiana are:
What are popular job titles related to Utilization Review Manager jobs in Indiana?
For Utilization Review Manager jobs in Indiana, the most frequently searched job titles are:
- Per Diem Utilization Review Nurse
- Utilization Review Physician
- Manager Utilization Management
- Contract Utilization Review Nurse
- Remote Utilization Review Social Worker
- Flex Schedule Remote Utilization Review Nurse
- Part Time Utilization Review Nurse
- Night Utilization Review Nurse
- Remote Concurrent Review Nurse
- No Experience Utilization Review Nurse
What job categories do people searching Utilization Review Manager jobs in Indiana look for?
The top searched job categories for Utilization Review Manager jobs in Indiana are:
What cities in Indiana are hiring for Utilization Review Manager jobs?
Cities in Indiana with the most Utilization Review Manager job openings:
Universal Health Services rating
6.9
Based on 254 frontline employees who took The Breakroom Quiz
456th of 898 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