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Utilization Review Rn Jobs in Indiana (NOW HIRING)

Bachelors Degree in Nursing with case management certification LICENSE/CERTIFICATION Licensed RN in ... DUTIES 1. Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay ...

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Evansville, Indiana Start Date: January 18, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $1686 ...

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Indianapolis, Indiana Start Date: June 14, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...

Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Indianapolis, Indiana Start Date: June 14, 2026 Profession: Registered Nurse (RN) Facility: Short Term Acute Care ...

Communicates and negotiates with payers to obtain approvals for the appropriate care level Maintains open collaborative active communication with the Utilization Review nurses' team to ensure timely ...

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Utilization Review Rn information

See Indiana salary details

$20

$40

$65

How much do utilization review rn jobs pay per hour?

As of May 31, 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 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 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 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 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 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:
What cities in Indiana are hiring for Utilization Review Rn jobs? Cities in Indiana with the most Utilization Review Rn job openings:
UTILIZATION REVIEW RN

UTILIZATION REVIEW RN

Schneck Medical Center

Seymour, IN • On-site

$30.72/hr

Full-time

Posted 5 days ago


Schneck Medical Center rating

7.3

Company rating: 7.3 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

345th of 990 rated hospitals


Job description

SALARY / 8:00am - 5:00pm / with on-call, weekend, & holiday rotation required;
Pay rate starts at $30.72/hr and increases with experience.
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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