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Utilization Review Rn Jobs in Indiana (NOW HIRING)

HHC

UTILIZATION REVIEW NURSE RN

Indianapolis, IN · On-site

FLSA Status Exempt #EXPRN Job Role Summary The Utilization Review Nurse works behind the scenes to maximize the quality and cost efficiency of health care services. Through regular reviews and audits ...

GQR

RN - Case Manager

Fort Wayne, IN · On-site

$2.4K - $2.5K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Fort Wayne, Indiana Start Date: September 21, 2026 Profession: Registered Nurse (RN) Facility: Hospital Estimated ...

GQR Global Markets

RN - Case Manager

Fort Wayne, IN · On-site

$2.4K - $2.5K/wk

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Fort Wayne, Indiana Start Date: September 21, 2026 Profession: Registered Nurse (RN) Facility: Hospital Estimated ...

UHS

MGR - UTILIZATION REVIEW / MGMT

Bloomington, IN · On-site

... oversees utilization management including, but not limited to: utilization review, case ... Must have Registered Nurse license or Master's Degree. Experience: 5-7 yrs acute inpatient ...

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Utilization Review Rn information

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How much do utilization review rn jobs pay per hour?

As of Sep 15, 2026, the average hourly pay for utilization review rn 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 is a utilization review RN?

A Utilization Review RN is a registered nurse who evaluates the necessity, appropriateness, and efficiency of healthcare services and treatments provided to patients. They review medical records, collaborate with healthcare teams, and ensure that patient care meets established guidelines and payer requirements. Their role helps control costs, optimize care, and support compliance with healthcare regulations. Utilization Review RNs often work in hospitals, insurance companies, or managed care organizations.

How does a utilization review RN collaborate with physicians and other healthcare professionals during the patient care review process?

A Utilization Review RN works closely with physicians, case managers, and other healthcare team members to ensure that patients receive appropriate care while adhering to regulatory and insurance guidelines. This collaboration often involves discussing clinical findings, clarifying documentation, and negotiating care plans to meet both patient needs and payer requirements. Effective communication and teamwork are essential, as Utilization Review RNs frequently serve as liaisons between clinical staff and insurance representatives to facilitate timely authorizations and prevent unnecessary delays in patient care.

What are the key skills and qualifications needed to thrive as a utilization review RN, and why are they important?

To thrive as a Utilization Review RN, you need a current RN license, strong clinical assessment skills, and knowledge of healthcare regulations and insurance guidelines. Familiarity with utilization management software, electronic health records (EHRs), and relevant certifications like CCM or ACM is often required. Excellent critical thinking, communication, and negotiation skills help you advocate for appropriate patient care while collaborating with providers and payers. These skills ensure cost-effective, quality care and compliance with regulatory standards in healthcare delivery.

What is the difference between Utilization Review Rn vs Case Manager?

AspectUtilization Review RnCase Manager
CredentialsRN license, certifications in utilization reviewRN license, certifications in case management
Work EnvironmentHospitals, insurance companies, healthcare facilitiesHospitals, community agencies, insurance companies
Primary FocusReviewing medical necessity and appropriateness of careCoordinating patient care and discharge planning

Utilization Review Rns primarily focus on evaluating the necessity of medical treatments, while Case Managers coordinate patient care and discharge planning. Both roles require RN licensure and certifications, but their daily responsibilities and work environments differ slightly, with Utilization Review Rns concentrating on review processes and Case Managers on patient advocacy and care coordination.

How to get into utilization review as a registered nurse?

To become a utilization review RN, you typically need a valid registered nurse license and experience in clinical settings. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or case management certification can enhance job prospects, and familiarity with electronic health records (EHR) systems is often required.

What are the most commonly searched types of Utilization Review Rn jobs in Indiana?

The most popular types of Utilization Review Rn jobs in Indiana are:

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For Utilization Review Rn jobs in Indiana, the most frequently searched job titles are:

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Cities in Indiana with the most Utilization Review Rn job openings:

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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Indiana as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 2% Contract, and 1% Nights. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $83,687 per year, or $40.2 per hour.

UTILIZATION REVIEW RN

Seymour, IN • On-site

Schneck Medical Center
Health Care and Social Assistance • 1 - 5K employees
Learn more about Schneck Medical Centerexternal

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Re-posted 12 days ago

Schneck Medical Center rating

7.2

Company rating: 7.2 out of 10

Based on 14 frontline employees who took The Breakroom Quiz

Job description

Job Details

SALARY / 8:00am - 5:00pm / with on-call, weekend, & holiday rotation required

ELIGIBLE FOR $2,000 SIGN-ON BONUS!

JOB REQUIREMENTS EDUCATION Minimum: Graduate of accredited school of nursing (BSN Preferred) Preferred: Bachelors Degree in Nursing with case management certification

LICENSE/CERTIFICATION Licensed RN in State of Indiana. Certification plan in place within 24 months of hire.

EXPERIENCE Minimum: 2-3 years of acute care clinical experience Preferred: 3-5 years of acute care clinical experience with strong knowledge of medical necessity criteria and payer requirements

JOB DUTIES

  • Utilization Review and Medical Necessity
  • Concurrent Review and Length of Stay Management
  • Retrospective Review
  • Payer Communication & Authorization
  • Denials Management and Appeals

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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