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Utilization Review Manager Jobs in Indiana (NOW HIRING)

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Utilization Review Manager information

See Indiana salary details

$37.1K

$86.6K

$159.4K

How much do utilization review manager jobs pay per year?

As of Jul 2, 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?

AspectUtilization Review ManagerUtilization Review Coordinator
CertificationsTypically requires certifications like CCM or ACUMay require similar certifications but often less advanced
Work EnvironmentSupervises review teams, manages processes in healthcare or insurance settingsPerforms case reviews, supports the review process under supervision
Employer & IndustryHospitals, insurance companies, healthcare organizationsInsurance 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 cities in Indiana are hiring for Utilization Review Manager jobs? Cities in Indiana with the most Utilization Review Manager job openings:
Utilization Review Educator

Utilization Review Educator

Beacon Health System

Granger, IN • On-site

Full-time

Posted 8 days ago


Beacon Health System rating

6.7

Company rating: 6.7 out of 10

Based on 139 frontline employees who took The Breakroom Quiz

563rd of 877 rated healthcare providers


Job description

Reports to the Manager/Utilization Review and Case Management. Is responsible for assessing, planning, coordinating and evaluating orientation, continuing education and in-service programs for staff which are competency based. Recommends improvements in the quality of utilization review practice and standards. Serves as a resource to staff. Assists with steps to resolve preventable denials and coordinates with the Manager to identify and correct weaknesses in the revenue cycle process that can mitigate future denials.
MISSION, VALUES and SERVICE GOALS
  • MISSION: We deliver outstanding care, inspire health, and connect with heart.
  • VALUES: Trust. Respect. Integrity. Compassion.
  • SERVICE GOALS: Personally connect. Keep everyone informed. Be on their team.

Orientation of New Hires
  • Develops curriculum and keeps current new hire orientation for all positions affecting UR at both hospitals and any other positions associated with UR Departments.
  • Develops schedules, teaching methods, evaluation tools, preceptor development programs, and coordinates for all parties a smooth onboarding and training process.
  • Works with manager to assure performance progress is documented and feedback whether positive or corrective for timely movement through orientation phase.

Continuing Education and Competency Validation
  • Assess learning needs of UR associates and develops plan, goals, and validates with management and associates.
  • Assures competency assessment of staff working in UR Process through audits, direct observations/discussions, and individual education plans as needed.
  • Responsible for all staff development activities around upgrades to UR tools, criteria sets, and other mechanisms/processes needed in UR process.
  • Assists as a resource regarding UR situations of concern and decision making.
  • Keeps records of all education and competency validation activities.

Project Management
  • Leads or participates in strategic initiatives in the revenue cycle where utilization review plays a role and communicates relevant information to other departments
  • Supports management communications and actions to assure effective change management culture in departments.

Performance/Process Improvement/Efficiency
  • Evaluates work processes, identifies inefficiencies, lack of standardization, and opportunities for improvement.
  • Collects information through data collection, observations, surveys, interviews, etc., to analyze the process.
  • Develops metrics for success and collaborative approach to design improvement.
  • Implements PDCA and LEAN tools as indicated to refine, measure, revise, and sustain improved processes in UR.
  • Monitors select measures for oversight committees and prepares timely reports.
ORGANIZATIONAL RESPONSIBILITIES
Associate complies with the following organizational requirements:
  • Attends and participates in department meetings and is accountable for all information shared.
  • Completes mandatory education, annual competencies and department specific education within established timeframes.
  • Completes annual employee health requirements within established timeframes.
  • Maintains license/certification, registration in good standing throughout fiscal year.
  • Direct patient care providers are required to maintain current BCLS (CPR) and other certifications as required by position/department.
  • Consistently utilizes appropriate universal precautions, protective equipment, and ergonomic techniques to protect patient and self.
  • Adheres to regulatory agency requirements, survey process and compliance.
  • Complies with established organization and department policies.
  • Available to work overtime in addition to working additional or other shifts and schedules when required.

Commitment to Beacon's six-point Operating System, referred to as The Beacon Way:
  • Leverage innovation everywhere.
  • Cultivate human talent.
  • Embrace performance improvement.
  • Build greatness through accountability.
  • Use information to improve and advance.
  • Communicate clearly and continuously.

Education and Experience
  • The knowledge, skills and abilities as indicated below are normally acquired through the successful completion of a Bachelor of Science in Nursing degree and current license to practice as a Registered Nurse in Indiana. A Master's degree in Nursing or advanced degree is preferred. Two years of recent utilization review/case management experience is required.

Knowledge & Skills
  • Demonstrates comprehensive knowledge of current training and adult education philosophies, techniques, programs, tools and equipment.
  • Demonstrates comprehensive knowledge of and competency in performing utilization review/case management functions.
  • Demonstrates critical thinking and analytical skills necessary to conduct training needs analysis, design programs, identify variances in standards of care.
  • Demonstrates ability to teach staff with a variety of educational backgrounds.
  • Demonstrates leadership skills necessary to coordinate activities and motivate all levels of staff.
  • Demonstrates initiative and high interest in teaching others.
  • Demonstrates well-developed interpersonal skills necessary to interface effectively with all levels of staff and customers and to conduct group and individual instruction.
  • Demonstrates well-developed communication skills, both verbal and written, necessary to communicate in an articulate and effective manner in front of groups. Relates to and provides effective feedback to the learner in a manner that is patient, constructive and enhances self-esteem.
  • Requires fundamental knowledge of the revenue cycle process, which includes such things as patient access, utilization review, charge capture, HIM and patient accounting.

Working Conditions
  • Works in a face paced environment requiring frequent changes in job demands.
  • May be exposed to bio-hazards.
  • Skillful in use of information technology including Excel, PowerPoint, Word and software tools.

Physical Demands
  • Requires the physical ability and stamina to perform the essential functions of the position.

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