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 ...
... management, and retro-authorizations Research and responds provider inquires concerning ... utilization review and authorization. Operates within program requirements in accordance with CMS ...
... management, and retro-authorizations Research and responds provider inquires concerning ... utilization review and authorization. Operates within program requirements in accordance with CMS ...
... denial management, and retro-authorizations • Research and responds provider inquires concerning unauthorized claims • Provides direct support to providers regarding utilization review and ...
... denial management, and retro-authorizations • Research and responds provider inquires concerning unauthorized claims • Provides direct support to providers regarding utilization review and ...
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 ...
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 ...
... 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 Coordinator
Plainfield, IN · On-site
$47K - $56K/yr
Case Management/Utilization Management * Review the treatment plan and advocate for additional services as indicated. * Promote effective use of resources for patients. * Ensure that patient rights ...
Utilization Review Coordinator
Plainfield, IN · On-site
$47K - $56K/yr
Case Management/Utilization Management * Review the treatment plan and advocate for additional services as indicated. * Promote effective use of resources for patients. * Ensure that patient rights ...
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 ...
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 ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
$30.72/hr
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
$30.72/hr
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 ...
Coordinate and support the hospital's Utilization Review and Case Management program to ensure appropriate level of care, efficient resource use, and timely discharge planning. * Review patient ...
Coordinate and support the hospital's Utilization Review and Case Management program to ensure appropriate level of care, efficient resource use, and timely discharge planning. * Review patient ...
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 ...
Utilization Review RN
Indianapolis, IN · On-site
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
Indianapolis, IN · On-site
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 ...
... 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 ...
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 Jun 9, 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 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 are the key skills and qualifications needed to thrive as a Utilization Review Manager, and why are they important?
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 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.
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 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:
- Remote Utilization Management Nurse
- Utilization Management Nurse Consultant
- Remote Utilization Management
- Per Diem Chart Review Nurse
- Utilization Review Physician
- Weekday Cvs Utilization Management Nurse
- Haven Detox
- Part Time Utilization Review Nurse
- No Experience Utilization Review Nurse
- Medical 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:
- Director Optum Utilization Review
- Registered Nurse Case Review
- Remote Lpn Utilization Review
- Anthem Utilization Review Nurse
- Online Utilization Review
- Lpn Utilization Review Work From Home
- Weekend Utilization Review
- Aetna Utilization Review Nurse
- Freelance International Utilization Review Nurse
- Optum Utilization Review Nurse
What cities in Indiana are hiring for Utilization Review Manager jobs? Cities in Indiana with the most Utilization Review Manager job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 9 days ago
Job description
About Us
Healing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
Overview
NeuroPsychiatric Hospitals of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
Responsibilities
Qualifications
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: 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 setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW
Healing Body and Mind.
NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it's needed most.
With locations in Indiana, Michigan, Texas, and Arizona, we're expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day
Overview
NeuroPsychiatric Hospitals of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.
Benefits of joining NPH
- Competitive pay rates
- Medical, Dental, and Vision Insurance
- NPH 401(k) plan with up to 4% Company match
- Employee Assistance Program (EAP) Programs
- Generous PTO and Time Off Policy
- Special tuition offers through Capella University
- Work/life balance with great professional growth opportunities
- Employee Discounts through LifeMart
Responsibilities
- Filing documents as needed.
- Initial Precertification with payors.
- Concurrent Clinical review with payors.
- Document in the electronic system daily in real time.
- Admission audit.
- Ensures that CON's/RON's and CMS certifications are completed by provider.
- Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
- Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
- Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
- Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
- Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
- Complies with hospital expectations regarding ethical behavior and standards of conduct.
- Complies with federal and hospital requirements in the areas of protected health information and patient information.
- Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
- Provides education to nursing staff. ;eadership team, and providers regarding documentation.
- Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.
Qualifications
Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.
Experience: 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 setting required.
Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.
Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW