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Utilization Review Rn Jobs in Indiana (NOW HIRING)

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 ...

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 ... Registered Nurse // HRS // Healthcare Resources // UM // Utilization Management // Case Management ...

Sinai Health System

RN Case Manager

Hammond, IN · On-site

The RN Case manager provides education to physicians and other members of the team on the issues related to utilization review including appropriateness of admission, level of care and external ...

TEEMA Group

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)

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Utilization Review Rn information

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How much do utilization review rn jobs pay per hour?

As of Aug 4, 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.

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.

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 knowledge of medical coding and insurance processes can enhance your qualifications. Gaining experience in case management or health insurance companies can also improve your chances of entering the field.

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.

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.
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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What cities in Indiana are hiring for Utilization Review Rn jobs? Cities in Indiana with the most Utilization Review Rn job openings:
What are popular job titles related to Utilization Review Rn jobs in IN? For Utilization Review Rn jobs in IN, the most frequently searched job titles are:
Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Indiana as of July 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 1% Temporary, and 3% Contract. Highlights an 91% Physical, 3% Hybrid, and 6% Remote job distribution, with an average salary of $83,687 per year, or $40.2 per hour.

UTILIZATION REVIEW RN

Schneck Medical Center

Seymour, IN • On-site

Full-time

Re-posted 11 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

420th of 1,054 rated hospitals

Job description

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.
EXPERIENCEMinimum: 2-3 years of acute care clinical experiencePreferred: 3-5 years of acute care clinical experience with strong knowledge of medical necessity criter and payer requirements
JOB DUTIES1. Utilization Review and Medical Necessity
2. Concurrent Review and Length of Stay Management
3. Retrospective Review
4. Payer Communication & Authorization
5. 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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