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Utilization Review Manager Jobs in Indiana (NOW HIRING)

ScionHealth

Case Manager II PRN

Indianapolis, IN · On-site

... utilization review and management, and discharge planning. Essential Functions Care Coordination ... Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.

UHS

UR Coordinator (PRN)

Kouts, IN · On-site

... managed care companies, insurance companies and other third party reviewers to establish the length of stay or number of certified days. • Coordinate with the insurance company doctor in appeals ...

Deaconess

Clinical Denial Analyst (RN)

Evansville, IN · On-site

$28.71 - $40.19/hr

Minimum of two (2) years performing utilization review, charge audit, case management or similar functions in an acute care or specialty hospital Preferred Certification/License/Experience: * BSN

Seven Healthcare

RN - Case Management

Fort Wayne, IN · On-site

$2.7K/wk

Utilization Review: Collaborate with the Care Team * Complete comprehensive patient assessments to ... Minimum of 2 years of Inpatient Case Manager experience * Competent with MCG and InterQual * Prefer ...

Powers Health

Manager Sourcing

Munster, IN · On-site

$43.45 - $68.50/hr

The Manager of Sourcing develops sourcing strategies that align with organizational goals ... utilization review and spend analysis. * Provide category expertise and experience to support ...

Powers Health

Manager Sourcing

Munster, IN

The Manager of Sourcing develops sourcing strategies that align with organizational goals ... utilization review and spend analysis. * Provide category expertise and experience to support ...

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All JobsUtilization Review Manager JobsUtilization Review Manager Jobs in Indiana

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 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:
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:
Utilization Review Manager jobs near you
Case Manager II PRN

Case Manager II PRN

ScionHealth

Indianapolis, IN • On-site

Per diem

Posted 28 days ago

ScionHealth rating

6.0

Company rating: 6.0 out of 10

Based on 48 frontline employees who took The Breakroom Quiz

731st of 877 rated healthcare providers

Job description

Kindred Hospital Indianapolis North is a 45-bed long-term acute care hospital offering the same in depth care you would receive in a traditional hospital, but for an extended recovery period. We partner with your physician and offer 24-hour clinical care seven days a week so you can start your journey to wellness. We are located within American National University community.
Job Summary
Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.
Essential Functions
Care Coordination
  • Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
  • Monitors all areas of patients' stay for effective care coordination and efficient care facilitation.
  • Remains current from a knowledge base perspective regarding reimbursement modalities, community resources, case management, psychosocial and legal issues that affect patients and providers of care.
  • Appropriately refers high risk patients who would benefit from additional support.
  • Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient's and family's ability to make informed decisions.
  • Demonstrates knowledge of the principles of growth and development over the life span and the skills necessary to provide age appropriate care to the patient population served.
  • Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimize resource utilization, provide family education and identified post hospital needs. Collaborates with clinical staff in the development and execution of the plan of care, and achievement of goals.
  • Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others in the planning of the patients' care throughout the care continuum.

Knowledge/Skills/Abilities/Expectations
  • Knowledge of government and non-government payor practices, regulations, standards and reimbursement.
  • Knowledge of Medicare benefits and insurance processes and contracts.
  • Knowledge of accreditation standards and compliance requirements.
  • Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
  • Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheet software.
  • Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtain cooperation/collaboration from hospital leadership, as well as physicians, payors and other external customers
  • Demonstrates good interpersonal skills when working or interacting with patients, their families and other staff members.
  • Approximate percent of time required to travel: 0%
  • Must read, write and speak fluent English.
  • Must have good and regular attendance.
  • Performs other related duties as assigned.

Qualifications
Education
  • Graduate of an accredited program required for RN. BSN preferred; or MSW/BSW with licensure as required by state regulations

Licenses/Certification
  • Healthcare professional licensure required as Registered Nurse, or Licensed Clinical Social Worker (LCSW) or Licensed Social Worker (LSW) if required by state regulations.
  • Certification in Case Management a plus.

Experience
  • Two years of experience in a healthcare setting preferred.
  • Prefer prior experience in case management, utilization review, or discharge planning.

What ScionHealth employees say

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