... utilization to meet business objectives. Enterprise Leadership * Lead actions and collaborate with ... Act as a Lilly Case Management Medical Review representative for both internal and external ...
... utilization to meet business objectives. Enterprise Leadership * Lead actions and collaborate with ... Act as a Lilly Case Management Medical Review representative for both internal and external ...
Plumbing Manager
Indianapolis, IN · On-site
$150K/yr
... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ... Proven experience managing teams and financial performance. * Strong communication, coaching, and ...
Plumbing Manager
Indianapolis, IN · On-site
$150K/yr
... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ... Proven experience managing teams and financial performance. * Strong communication, coaching, and ...
Plumbing Manager
Indianapolis, IN · On-site
$150K/yr
... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ... Proven experience managing teams and financial performance. * Strong communication, coaching, and ...
Quick apply
Plumbing Manager
Indianapolis, IN · On-site
$150K/yr
... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ... Proven experience managing teams and financial performance. * Strong communication, coaching, and ...
Plumbing Manager
Indianapolis, IN · On-site
$150K/yr
... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ... Proven experience managing teams and financial performance. * Strong communication, coaching, and ...
Plumbing Manager
Indianapolis, IN · On-site
$150K/yr
... utilization. * Review scheduling efficiency, job flow, and capacity planning to minimize downtime ... Proven experience managing teams and financial performance. * Strong communication, coaching, and ...
Secondary Review Nurse - Indiana
Indianapolis, IN · On-site
$29 - $52/hr
The Secondary Review Nurse plays a critical role in evaluating clinical requests for Home and ... Utilization Management experience * Case Management experience * Knowledge of state and federal ...
Secondary Review Nurse - Indiana
Indianapolis, IN · On-site
$29 - $52/hr
The Secondary Review Nurse plays a critical role in evaluating clinical requests for Home and ... Utilization Management experience * Case Management experience * Knowledge of state and federal ...
Secondary Review Nurse - Indiana
Indianapolis, IN · Remote
$29 - $52/hr
The Secondary Review Nurse plays a critical role in evaluating clinical requests for Home and ... Utilization Management experience * Case Management experience * Knowledge of state and federal ...
Secondary Review Nurse - Indiana
Indianapolis, IN · Remote
$29 - $52/hr
The Secondary Review Nurse plays a critical role in evaluating clinical requests for Home and ... Utilization Management experience * Case Management experience * Knowledge of state and federal ...
Case Manager
Anderson, IN · On-site
$17.25 - $22.25/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
Anderson, IN · On-site
$17.25 - $22.25/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
$19 - $24.50/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
$19 - $24.50/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
Indianapolis, IN · On-site
$19 - $24.50/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
Indianapolis, IN · On-site
$19 - $24.50/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
$17.25 - $22.25/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Case Manager
$17.25 - $22.25/hr
The Case Manager is a qualified registered nurse with the ability to provide and oversee the care ... Participates in clinical record/utilization review of medical records and quality assurance and ...
Medical Management Nurse
Indianapolis, IN · On-site
Requires a minimum of 4 years care management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education ...
Medical Management Nurse
Indianapolis, IN · On-site
Requires a minimum of 4 years care management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education ...
Medical Management Nurse
Indianapolis, IN · On-site
Requires a minimum of 4 years care management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education ...
Medical Management Nurse
Indianapolis, IN · On-site
Requires a minimum of 4 years care management or case management experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education ...
Medical Case Manager I
$63K - $95K/yr
A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...
Quick apply
Medical Case Manager I
$63K - $95K/yr
A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...
Medical Case Manager I
Carmel, IN · On-site
$63K - $95K/yr
A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...
Medical Case Manager I
Carmel, IN · On-site
$63K - $95K/yr
A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...
Medical Case Manager I
Carmel, IN · On-site
$63K - $95K/yr
A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...
Medical Case Manager I
Carmel, IN · On-site
$63K - $95K/yr
A cost containment background, such as utilization review or managed care is helpful * Strong interpersonal, time management, and organizational skills * Computer proficiency and technical aptitude ...
Previous experience with utilization review and/or prior authorization. * Clinical case management experience in an inpatient or outpatient setting. * Ability to talk, type and critically think at ...
New
Previous experience with utilization review and/or prior authorization. * Clinical case management experience in an inpatient or outpatient setting. * Ability to talk, type and critically think at ...
New
Post-Doctoral Fellow - Behavioral Health
$42K - $57K/yr
... Manager. * Assist in educating clinic staff on behavioral health services and integrated care ... utilization review, and quality improvement initiatives. Administrative & Collaborative ...
Post-Doctoral Fellow - Behavioral Health
$42K - $57K/yr
... Manager. * Assist in educating clinic staff on behavioral health services and integrated care ... utilization review, and quality improvement initiatives. Administrative & Collaborative ...
Appeal Reviews. * Supports clinicians to ensure timely and consistent responses to members and ... Utilization Management or Appeals experience preferred. For candidates working in person or ...
Appeal Reviews. * Supports clinicians to ensure timely and consistent responses to members and ... Utilization Management or Appeals experience preferred. For candidates working in person or ...
Appeals Medical Director- Cardiology
Indianapolis, IN · On-site
$247K - $446K/yr
Appeal Reviews. * Supports clinicians to ensure timely and consistent responses to members and ... Utilization Management or Appeals experience preferred. For candidates working in person or ...
Appeals Medical Director- Cardiology
Indianapolis, IN · On-site
$247K - $446K/yr
Appeal Reviews. * Supports clinicians to ensure timely and consistent responses to members and ... Utilization Management or Appeals experience preferred. For candidates working in person or ...
Appeals Medical Director- Cardiology
Indianapolis, IN · On-site
$247K - $446K/yr
Appeal Reviews. * Supports clinicians to ensure timely and consistent responses to members and ... Utilization Management or Appeals experience preferred. For candidates working in person or ...
Appeals Medical Director- Cardiology
Indianapolis, IN · On-site
$247K - $446K/yr
Appeal Reviews. * Supports clinicians to ensure timely and consistent responses to members and ... Utilization Management or Appeals experience preferred. For candidates working in person or ...
Utilization Review Manager information
See Anderson, IN salary details
$33.8K - $43.9K
9% of jobs
$51.4K is the 25th percentile. Wages below this are outliers.
$43.9K - $54K
22% of jobs
$54K - $64.2K
11% of jobs
The median wage is $70.4K / yr.
$64.2K - $74.3K
14% of jobs
$74.3K - $84.4K
12% of jobs
$90.7K is the 75th percentile. Wages above this are outliers.
$84.4K - $94.5K
13% of jobs
$94.5K - $104.7K
13% of jobs
$104.7K - $114.8K
5% of jobs
$114.8K - $124.9K
2% of jobs
$124.9K - $135K
0% of jobs
$135K - $145.1K
0% of jobs
$33.8K
$78.9K
$145.1K
How much do utilization review manager jobs pay per year?
Is utilization review a stressful job?
What are some common challenges faced by utilization review managers in balancing patient care and cost efficiency?
What are the key skills and qualifications needed to thrive as a utilization review manager?
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?

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 9 days ago
Eli Lilly and Company rating
8.8
Based on 63 frontline employees who took The Breakroom Quiz
11th of 86 rated pharmaceutical
Job description
At Lilly, the work is demanding because patients are waiting. We unite caring with discovery to help make life better for people around the world, knowing that every decision, every detail, and every day matters. Headquartered in Indianapolis, Indiana, our over 50,000 employees around the globe take on complex challenges to discover and deliver life-changing medicines, strengthen how health is understood and managed, and support the communities we serve. This is hard, urgent, selfless work-but it's work worth doing. If you're driven by purpose and ready to bring your best to work that truly matters for patients, we invite you to join us.
Leadership in Medical Review
- Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists.
- Build deep regulatory and technical expertise through recruitment, development, and retention of staff.
- Facilitate, train and mentor Case Management Medical Reviewers in the responsibilities of the role.
- Provide feedback and coaching, support short and long-term development plans, and ensure appropriate individual recognition.
- Oversee the medical evaluation of safety of Individual Case Safety Reports for all assigned compounds across their life cycle to inform the safety profile of the therapeutic area portfolio.
- Develop, maintain, and share technical expertise and medical knowledge in the therapeutic area.
- Provide strong global medical leadership that influences scientific and process improvements and drive change within the organization.
- Lead and participate in process improvement and innovation projects to support the safety of all assigned compounds.
- Participate in the development and implementation of the functional strategic plan for Case Management Medical Review.
- Manage resources to meet business objectives and future needs within the therapeutic area in collaboration with leaders across the global team.
- Collaborate cross-functionally to ensure alignment of goals and deliverables, readjusting as business needs dictate.
- Partner closely with global GPS partners for efficient resource forecasting, planning, and utilization to meet business objectives.
Enterprise Leadership
- Lead actions and collaborate with GPS teams to ensure appropriate interaction, communication, and high-quality medical evaluation of safety within the therapeutic area.
- Act as a Lilly Case Management Medical Review representative for both internal and external customers, interacting as described in corporate guidelines and policies.
- Build strong relationships with key customers, representing and championing the role of safety in the organization.
- Collaborate with Affiliates, Business Units, and Clinical Development teams regarding areas of relevant medical review expertise and responsibility.
- Lead actions required to manage or clarify a safety issue in collaboration with the responsible global teams.
- Understand the roles and responsibilities of the EU qualified person (QP) and ensure support to the fulfillment of QP's legal responsibilities is provided when required.
Minimum Qualification Requirements:
- Medical Doctor or Doctor of Osteopathy. Must be board eligible or certified in appropriate specialty/subspecialty or have completed the comparable level of post-medical school clinical training relevant to the country of hiring.
- US trained physicians must have achieved board eligibility or certification. Foreign medical graduates (in US based jobs) who are not US board eligible or certified may be hired directly for employment in the US at the discretion of the Chief Medical Officer.
- Non-US trained physicians must have completed education and training at a medical school that meets the minimum requirements substantially equivalent to the requirements of medical schools accredited by the Liaison Committee on Medical Education (LCME). For the recognized list of foreign medical schools and the disapproved list, see PLA: Physicians Licensing Information and Medical Education | MBC.
Additional Preferences:
- 5 years of clinical development or pharmacovigilance experience preferred.
- Knowledge of drug development process.
- Fluent in English with highly effective written and verbal communication skills.
- Strong clinical/diagnostic skills.
- Excellent interpersonal, organizational and negotiation skills.
- Ability to work on multiple projects and function effectively in a fast-paced matrixed environment.
- Ability to prioritize tasks and shift priorities rapidly to meet tight deadlines
- Ability to influence others (both cross-functionally and within the function) in order to create a positive working environment.
- Excellent teamwork skills.
- Willing to engage in domestic and international travel to the degree appropriate to support the business of the team.
Lilly is dedicated to helping individuals with disabilities to actively engage in the workforce, ensuring equal opportunities when vying for positions. If you require accommodation to submit a resume for a position at Lilly, please complete the accommodation request form (https://careers.lilly.com/us/en/workplace-accommodation) for further assistance. Please note this is for individuals to request an accommodation as part of the application process and any other correspondence will not receive a response.
Lilly is proud to be an EEO Employer and does not discriminate on the basis of age, race, color, religion, gender identity, sex, gender expression, sexual orientation, genetic information, ancestry, national origin, protected veteran status, disability, or any other legally protected status.
Our employee resource groups (ERGs) offer strong support networks for their members and are open to all employees. Our current groups include: Africa, Middle East, Central Asia (AMECA), Black Employees at Lilly (BE@Lilly), Chinese Culture Network (CCN), EnAble, Evolve, Lilly Indian Network (LIN), Organization of Latinx at Lilly (OLA), Pride (LGBTQ+ Allies), Veterans Leadership Network (VLN) and Women's Initiative for Leading at Lilly (WILL).
Actual compensation will depend on a candidate's education, experience, skills, and geographic location. The anticipated wage for this position is
$225,000 - $330,000Full-time equivalent employees also will be eligible for a company bonus (depending, in part, on company and individual performance). In addition, Lilly offers a comprehensive benefit program to eligible employees, including eligibility to participate in a company-sponsored 401(k); pension; vacation benefits; eligibility for medical, dental, vision and prescription drug benefits; flexible benefits (e.g., healthcare and/or dependent day care flexible spending accounts); life insurance and death benefits; certain time off and leave of absence benefits; and well-being benefits (e.g., employee assistance program, fitness benefits, and employee clubs and activities).Lilly reserves the right to amend, modify, or terminate its compensation and benefit programs in its sole discretion and Lilly's compensation practices and guidelines will apply regarding the details of any promotion or transfer of Lilly employees.
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About Eli Lilly
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Eli Lilly, based in Indianapolis, IN, US, is one of the pioneers in the pharmaceutical industry with a rich history dating back to 1876. This global pharmaceutical company focuses on discovering, developing, manufacturing and selling pharmaceutical products in approximately 120 countries. The company's product categories include endocrinology, oncology, cardiovascular, neuroscience, and immunology. Having invested over $9 billion in research and development in the past decade, Eli Lilly is also committed to creating high-quality medicines that meet real needs. As a recipient of several awards and recognitions, Eli Lilly is known for its focus on life-saving research and drug development. Their mission is to make medicines that help people live longer, healthier, and more active lives.
Industry
Pharmaceutical product wholesalers
Company size
10,000+ Employees
Headquarters location
Indianapolis, IN, US
Year founded
1876