... Utilization Management RN - HYBRI D , you'll provide care to our clients employees and their dependents of at Cummins Engin e in our Health Center located in Columbus, I N Schedule * 8:00 am - 5:00 ...
New
... Utilization Management RN - HYBRI D , you'll provide care to our clients employees and their dependents of at Cummins Engin e in our Health Center located in Columbus, I N Schedule * 8:00 am - 5:00 ...
New
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Quick apply
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Rep I
Indianapolis, IN · On-site
$15.96 - $18/hr
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
The Utilization Management Representative I is responsible for coordinating cases for ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
UR Specialist-Non Exempt
Shelbyville, IN · On-site
Bachelor's degree in nursing, healthcare management, or a related field * License(s) or ... related to utilization review. Demonstrated ability to work independently and manage multiple ...
UR Specialist-Non Exempt
Shelbyville, IN · On-site
Bachelor's degree in nursing, healthcare management, or a related field * License(s) or ... related to utilization review. Demonstrated ability to work independently and manage multiple ...
UR Specialist-Non Exempt
Shelbyville, IN · On-site
Bachelor's degree in nursing, healthcare management, or a related field * License(s) or ... related to utilization review. Demonstrated ability to work independently and manage multiple ...
UR Specialist-Non Exempt
Shelbyville, IN · On-site
Bachelor's degree in nursing, healthcare management, or a related field * License(s) or ... related to utilization review. Demonstrated ability to work independently and manage multiple ...
Performs on site and office review of various clinical resident care services and nursing management operations at the long term care facilities and prepares related reports for the long term care ...
Performs on site and office review of various clinical resident care services and nursing management operations at the long term care facilities and prepares related reports for the long term care ...
Performs on site and office review of various clinical resident care services and nursing management operations at the long term care facilities and prepares related reports for the long term care ...
Performs on site and office review of various clinical resident care services and nursing management operations at the long term care facilities and prepares related reports for the long term care ...
Clinical Review Nurse I (US)
Indianapolis, IN · On-site
$67K - $110K/yr
Sign on Bonus: $ 3500 Clinical Review Nurse I Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
Clinical Review Nurse I (US)
Indianapolis, IN · On-site
$67K - $110K/yr
Sign on Bonus: $ 3500 Clinical Review Nurse I Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... Facilitating discharge planning by working closely with Nurses and Clinical Social Workers and/or ...
RN Care Manager
Evansville, IN · On-site
$85K - $95K/yr
Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS, prevent readmissions, improve outcomes ✅ What You Bring: * Active RN license (Indiana or compact)
Quick apply
RN Care Manager
Evansville, IN · On-site
$85K - $95K/yr
Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS, prevent readmissions, improve outcomes ✅ What You Bring: * Active RN license (Indiana or compact)
Ensures standards for admission, utilization review, and concurrent review are followed. Staff Leadership and Development * Supervises nursing personnel and provides clinical guidance to residential ...
Ensures standards for admission, utilization review, and concurrent review are followed. Staff Leadership and Development * Supervises nursing personnel and provides clinical guidance to residential ...
Ensures standards for admission, utilization review, and concurrent review are followed. Staff Leadership and Development Supervises nursing personnel and provides clinical guidance to residential ...
Ensures standards for admission, utilization review, and concurrent review are followed. Staff Leadership and Development Supervises nursing personnel and provides clinical guidance to residential ...
NURSE MANAGER
Gary, IN · On-site
$95 - $125/hr
Ensures standards for admission, utilization review, and concurrent review are followed. Staff Leadership and Development Supervises nursing personnel and provides clinical guidance to residential ...
NURSE MANAGER
Gary, IN · On-site
$95 - $125/hr
Ensures standards for admission, utilization review, and concurrent review are followed. Staff Leadership and Development Supervises nursing personnel and provides clinical guidance to residential ...
Utilization Review Nurse information
See Indiana salary details
$20.36 - $24.48
2% of jobs
$24.48 - $28.59
9% of jobs
$31.41 is the 25th percentile. Wages below this are outliers.
$28.59 - $32.71
21% of jobs
The median wage is $36.04 / hr.
$32.71 - $36.83
23% of jobs
$36.83 - $40.94
13% of jobs
$44.15 is the 75th percentile. Wages above this are outliers.
$40.94 - $45.06
10% of jobs
$45.06 - $49.18
8% of jobs
$49.18 - $53.30
5% of jobs
$53.30 - $57.41
5% of jobs
$57.41 - $61.53
2% of jobs
$61.53 - $65.65
2% of jobs
$20
$40
$65
How much do utilization review nurse jobs pay per hour?
As of Aug 23, 2026, the average hourly pay for utilization review nurse in Indiana is $40.23, according to ZipRecruiter salary data. Most workers in this role earn between $31.78 and $46.20 per hour, depending on experience, location, and employer.
What does a utilization review nurse do?
A Utilization Review Nurse is responsible for evaluating the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, coordinate with healthcare providers, and ensure that care meets established guidelines and insurance requirements. Their primary goal is to ensure patients receive appropriate care while helping to manage healthcare costs and prevent unnecessary procedures.
What does a utilization review nurse do?
A utilization review nurse determines the best course of treatment for a patient using preapproved policy criteria. Utilization review nurses collect and review patient records, clinical documentation, and billing information to recommend the best use of patient care resources. Their assessments help determine the length of hospital stays, the effectiveness of the care plan, and the necessity of the services administered. Utilization review nurses inform and educate patients about their options based on their insurance benefits and limitations. Utilization review nurses also assess patient care services in clinical appeals for approval or denial.
What are some typical challenges utilization review nurses face when communicating with healthcare providers and insurance companies?
Utilization Review Nurses often need to balance clinical judgment with insurance guidelines, which can lead to challenging conversations with providers who may disagree with coverage decisions. They must clearly explain the rationale behind approvals or denials and ensure all documentation is thorough and compliant. Navigating differing priorities while maintaining positive, professional relationships is key, and strong communication skills help facilitate collaboration and resolve conflicts efficiently.
What are the key skills and qualifications needed to thrive as a utilization review nurse, and why are they important?
To thrive as a Utilization Review Nurse, you need a strong background in clinical nursing, critical thinking, and knowledge of healthcare regulations, usually supported by an RN license and nursing degree. Familiarity with utilization management software, medical coding systems (like ICD-10 and CPT), and case management certifications (such as CCM or URAC) is typically required. Excellent communication, negotiation, and organizational skills help you collaborate with providers and advocate for patient care while managing complex cases. These skills ensure appropriate resource use, regulatory compliance, and high-quality patient outcomes in healthcare settings.
What is the difference between Utilization Review Nurse vs Case Manager?
| Aspect | Utilization Review Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certification in utilization review (e.g., URAC) | RN license, case management certification (e.g., CCM) |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, insurance companies, community health settings |
| Employer & Industry Usage | Primarily in insurance and healthcare organizations for reviewing medical necessity | In healthcare and insurance for coordinating patient care and discharge planning |
Utilization Review Nurses focus on evaluating the necessity and appropriateness of medical services, often working in insurance or healthcare settings. Case Managers coordinate patient care, discharge planning, and resource management. While both roles require RN licensure and related certifications, their primary responsibilities differ: UR Nurses review medical necessity, whereas Case Managers facilitate patient care and services.
More about Utilization Review Nurse jobs
What are the most commonly searched types of Utilization Review Nurse jobs in Indiana?
The most popular types of Utilization Review Nurse jobs in Indiana are:
What are popular job titles related to Utilization Review Nurse jobs in Indiana?
For Utilization Review Nurse jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Utilization Review Nurse jobs in Indiana look for?
The top searched job categories for Utilization Review Nurse jobs in Indiana are:
What cities in Indiana are hiring for Utilization Review Nurse jobs?
Cities in Indiana with the most Utilization Review Nurse job openings:
What are popular job titles related to Utilization Review Nurse jobs in IN?
For Utilization Review Nurse jobs in IN, the most frequently searched job titles are:
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 3 days ago
New
Premise Health rating
8.0
Based on 43 frontline employees who took The Breakroom Quiz
87th of 893 rated healthcare providers
Job description
Premise's mission is to help people get, stay, and be well. We hope you will join us in our mission and experience why amazing health starts with amazing healthcare. For more information, visit www.jobs.premisehealth.com.
Premise's mission is to help people get, stay, and be well. We hope you will join us in our mission and experience why amazing health starts with amazing healthcare. For more information, visit www.jobs.premisehealth.com
As a Full Time Utilization Management RN - HYBRID, you'll provide care to our clients employees and their dependents of at Cummins Engine in our Health Center located in Columbus, IN
Schedule
- 8:00 am - 5:00 pm
- Mon, Thu & Fri Onsite
- Tue & Wed Remote
Make an impact beyond the bedside: Use your clinical expertise to drive quality improvement, patient safety, regulatory readiness, and better outcomes across the health center.
Bring structure to quality & compliance: Own quality initiatives, employee health tracking, clinical competencies, audits, and regulatory requirements while partnering with leaders across the organization.
A great fit for an organized, detail-oriented RN: Put your critical-thinking and problem-solving skills to work through quality projects, metrics tracking, process improvement, and root-cause analysis.
What You'll Do
- Manages policy and document system to include creating, updating, and maintaining all forms (in English or other specified foreign languages).
- Assists with development of monthly reports for various purposes including department updates, quality reports, etc.
- Manages key presentation material including development, formatting, technical assistance with Excel, PowerPoint, Word, PDF files, Acrobat etc. documents.
- Assists in managing multiple platforms and programs: organize and maintain various enterprise documents and spreadsheets
- Manages the Site Accreditation Audit schedule as directed and collect, compile and report results.
What You'll Bring
- Bachelor’s Degree in Healthcare related field
- 3 years’ experience in Healthcare setting progressively responsible for quality management/programs
- Experience in data and trend analysis, report preparation, policy/procedure development
- Working experience applying concepts of process improvement for the purpose for developing root cause analysis, failure mode effect analysis and investigate satisfaction/concerns in the identification and the elimination of waste by preventative action design, efficiency, effectiveness, and sustainability of quality management process.
- Work in the onsite care model preferred
Work-life balance is at the foundation of how decisions are made and where Premise is headed. We can only help people get, stay, and be well if we do the same for ourselves. In addition to competitive pay, Premise offers full-time team members benefits including medical, dental, vision, life and disability insurance, a 401(k) program with company match, paid holidays and vacation time, a company-sponsored wellness program, EAP, access to virtual primary care and virtual behavioral health at no cost for team members and their dependents. Additional benefits can be viewed here: https://jobs.premisehealth.com/benefits.
Premise is an equal opportunity employer; we value inclusion and do not discriminate based on race, color, religion, creed, national origin or ancestry, ethnicity, sex (including pregnancy and related conditions), gender identity or expression, sexual orientation, age, physical or mental disability, genetic information, past, current or prospective service in the uniformed services, or any other characteristic protected under applicable federal, state, or local law.#NRS123
What Premise Health employees say
Pay
Benefits
Hours and flexibility
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Get the full story on Breakroom
About Premise Health
Sourced by ZipRecruiter
Premise Health is the world's leading direct healthcare provider and one of the largest digital providers in the country, serving over 11 million eligible lives across more than 2,500 of the largest commercial and municipal employers in the U.S. Premise partners with its clients to offer fully connected care - in-person and in the digital environment. It operates more than 800 onsite and nearsite wellness centers in 45 states and Guam, delivering care through the Digital Wellness Center and onsite, nearsite, mobile, and event solutions. Premise delivers value by simplifying complexity and breaking down barriers to give diverse member populations access to convenient, integrated, high-quality care. We offer more than 30 products, delivering the breadth and depth of care required to serve organizations' total populations. The result is healthcare that meets the needs of members and their families, helping them live healthier while lowering costs for organizations.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Brentwood, TN, US
Year founded
1975