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Utilization Review Rn Jobs in Indiana (NOW HIRING)

SIHO Insurance Services, Inc.

Be Seen First

Utilization Management Nurse

Columbus, IN · On-site

This position is reserved for a licensed Registered Nurse who will perform the Utilization ... By performing review of services prospectively, retrospectively, and throughout the episode of care ...

Suburban Home Health

OASIS Review Nurse

Noblesville, IN · On-site

The Utilization Review Nurse is responsible for reviewing patient assessments to assist the Quality ... Must possess current license as a Registered Nurse with the State of Indiana Health Professions ...

TEEMA Group

RN Case Manager

Evansville, IN · On-site

$83K - $93K/yr

RN Case Manager 📍 Location: Evansville, IN 💼 Schedule: Full-Time | Monday-Friday ⏰ Hours ... Conduct utilization review (UR) and ensure appropriate level of care * Collaborate with physicians ...

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)

TEEMA Group

Registered Nurse - RN

Evansville, IN · On-site

$85K - $950K/yr

The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...

TEEMA Group

Registered Nurse - RN

Evansville, IN · On-site

$85K - $95K/yr

The Registered Nurse (RN) Care Manager plays a vital role in providing exceptional, patient ... Participate actively in team meetings, quality improvement projects, and utilization review ...

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All JobsUtilization Review Rn JobsUtilization Review Rn Jobs in Indiana

Utilization Review Rn information

See Indiana salary details

$20

$40

$65

How much do utilization review rn jobs pay per hour?

As of Jun 12, 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.

How do I become a utilization review RN?

To become a utilization review RN, you typically need to hold a valid registered nurse (RN) license and have experience in clinical nursing. Additional certifications such as the Certified Professional in Healthcare Quality (CPHQ) or Utilization Review Certification (URAC) can enhance job prospects, and strong knowledge of medical coding, insurance policies, and healthcare regulations is important.

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 does an RN utilization review do?

An RN utilization review evaluates medical records and treatment plans to determine the appropriateness, necessity, and efficiency of healthcare services. They ensure compliance with insurance policies and clinical guidelines, often using electronic health records and requiring knowledge of coding and documentation standards. This role supports cost-effective patient care and involves collaboration with healthcare providers and insurance companies.

How to make $300,000 a year as a nurse?

To earn $300,000 annually as a Utilization Review RN, professionals typically need extensive experience, advanced certifications such as CCM or ANCC, and may work in high-paying settings like insurance companies or healthcare consulting firms. Increasing specialization, taking on leadership roles, or working overtime can also boost income, but reaching this level often requires a combination of skills, experience, and strategic career moves.

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 make $150,000 as a nurse?

A Utilization Review RN can earn $150,000 by gaining extensive experience, obtaining certifications such as CCM or ANCC, and working in high-paying settings like insurance companies or managed care organizations. Advanced skills in case management, strong clinical knowledge, and sometimes working overtime or in leadership roles can also contribute to higher earnings.

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:
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Utilization Review Rn jobs near you
Infographic showing various Utilization Review Rn job openings in Indiana as of June 2026, with employment types broken down into 81% Full Time, 13% Part Time, and 6% Contract. Highlights an 87% In-person, and 13% Remote job distribution, with an average salary of $83,687 per year, or $40.2 per hour.
Utilization Reviewer - Full Time

Utilization Reviewer - Full Time

Rehabilitation Hospital of Indiana

Indianapolis, IN • On-site

Full-time

Retirement

Posted 21 days ago

Job description

The Rehabilitation Hospital of Indiana (RHI) is nationally ranked among the Best Hospitals for Rehabilitation by U.S. News and World Report for 2025-2026 and the Best Rehabilitation Hospital in Indiana for the third year in a row. RHI provides high quality, evidence-based rehabilitation services to those facing life-changing injuries or illness. RHI is the only Traumatic Brain Injury (TBI) Model System in the state of Indiana and one of only 16 in the U.S We offer a competitive compensation and benefits package, along with a 401k match and tuition reimbursement program.

Summary:

The Utilization Reviewer contributes to assessment and planning by performing a thorough review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful transition to the discharge setting and or goal achievement, and durability of outcome.

Essential Functions

  • Assesses all of patient's payer sources for rehabilitation course, determines resources available for patient, and ensures maximal use of available health coverage resources for each patient.
  • Completes pre-certification and prior authorization timely for admission and or services.
  • Documents all insurance information appropriately on forms and in computer system as applicable.
  • Functions as liaison with payer representatives to manage the rehabilitation process in keeping with the patient's financial resources, including verification of benefits for this and future settings.
  • Completes retro authorizations as applicable and ensures follow through relative to authorizations for all services through the complete revenue cycle.
  • Other duties as assigned.

Education and Experience

  • Greater than 2 years of UR experience with a strong clinical background and competence with a rehabilitation population.
  • Bachelor's degree in related field with 3-5 years' experience
  • LPN or RN experience preferred

Hours

  • Monday - Friday (8:30am-5:00pm)

The Rehabilitation Hospital of Indiana is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, or any other characteristic protected by law.