Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Participate in quality improvement, utilization review, and patient safety initiatives * Collaborate with practice leadership to support efficient clinical operations and workflow improvements ...
Participate in quality improvement, utilization review, and patient safety initiatives * Collaborate with practice leadership to support efficient clinical operations and workflow improvements ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
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Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Huntington, IN · On-site
$82K - $114K/yr
Participate in facility performance improvement and utilization review activities. * Conduct peer reviews and contribute to the development and evaluation of policies and procedures. * Assist in ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$154K - $199K/yr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Huntington, IN · On-site
... utilization review, quality assurance, resident care conferences, admissions, department head meetings, and community education planning Ensure timely and accurate completion of Minimum Data Set (MDS ...
Huntington, IN · On-site
... utilization review, quality assurance, resident care conferences, admissions, department head meetings, and community education planning Ensure timely and accurate completion of Minimum Data Set (MDS ...
Kokomo, IN · On-site
$190 - $270/hr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Kokomo, IN · On-site
$190 - $270/hr
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives * Engage in patient satisfaction efforts and managed care programs (including Medicaid) * Participate ...
Perform administrative tasks such as department utilization review, including but not limited to, checking Medicaid eligibility for designated program clientele to ensure reimbursement for medically ...
Perform administrative tasks such as department utilization review, including but not limited to, checking Medicaid eligibility for designated program clientele to ensure reimbursement for medically ...
Perform administrative tasks such as department utilization review, including but not limited to, checking Medicaid eligibility for designated program clientele to ensure reimbursement for medically ...
Perform administrative tasks such as department utilization review, including but not limited to, checking Medicaid eligibility for designated program clientele to ensure reimbursement for medically ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
Marion, IN · On-site
$89K - $121K/yr
The Physician Assistant will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
Marion, IN · On-site
$89K - $121K/yr
The Physician Assistant will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
The Nurse Practitioner will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
$89K - $121K/yr
The Physician Assistant will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
$89K - $121K/yr
The Physician Assistant will accurately document patient interactions in the electronic health record, participate in utilization review processes to ensure patient care and collaborate with ...
Participate in quality improvement, utilization review, and patient safety initiatives * Support care gap closure and population health management strategies * Engage in value-based care programs ...
Participate in quality improvement, utilization review, and patient safety initiatives * Support care gap closure and population health management strategies * Engage in value-based care programs ...
$21.12 - $25.39
2% of jobs
$25.39 - $29.66
9% of jobs
$32.59 is the 25th percentile. Wages below this are outliers.
$29.66 - $33.93
21% of jobs
The median wage is $37.39 / hr.
$33.93 - $38.21
23% of jobs
$38.21 - $42.48
13% of jobs
$45.80 is the 75th percentile. Wages above this are outliers.
$42.48 - $46.75
10% of jobs
$46.75 - $51.02
8% of jobs
$51.02 - $55.29
5% of jobs
$55.29 - $59.56
5% of jobs
$59.56 - $63.83
2% of jobs
$63.83 - $68.11
2% of jobs
$21
$41
$68
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.
The most popular types of Utilization Review jobs in Marion, IN are:
For Utilization Review jobs in Marion, IN, the most frequently searched job titles are:
The top searched job categories for Utilization Review jobs in Marion, IN are:
Cities near Marion, IN with the most Utilization Review job openings:
$154K - $199K/yr
Full-time
Re-posted 3 days ago
7.5
Based on 8 frontline employees who took The Breakroom Quiz
Jane Pauley Community Health Center (JPCHC) is seeking a Board-Certified/Board-Eligible Outpatient Pediatrician to join a thriving pediatric practice at our Kokomo Pediatrics Health Center, part of our growing network of Community Health Centers.
This role offers the unique opportunity to work in a large, integrated, multi service Federally Qualified Health Center (FQHC) serving an underserved urban population. In addition to joining a mission-driven organization, you'll be part of a collaborative care team including clinical and in-house social support staff allowing you to focus on delivering high-quality, patient-centered care. JPCHC is known as a pillar of care in Marion County, with locations such as the Washington Pavilion exemplifying our commitment to accessible, inclusive healthcare. We value candidates who bring a positive, team-oriented approach and demonstrate a consistent, consecutive history in employment or training.
At JPCHC, you will join a mission-driven, family-friendly, and collaborative care model with access to clinical and in-house social support teams, enabling you to focus on delivering exceptional patient-centered care.
Provide full-time, on-site outpatient pediatric care
Ensure continuity of care within JPCHC's coordinated inpatient and outpatient resources
Refer patients within JPCHC's network, prioritizing patient preference and clinical judgment
Provide medical direction and supervision to care team members
Support staff education and pediatric clinical training
Lead and participate in quality assurance, utilization review, and clinical pathway initiatives
Engage in patient satisfaction efforts and managed care programs (including Medicaid)
Participate in equitable after-hours call rotation in collaboration with JPCHC leadership
Participate in local and statewide child health outreach activities
Represent JPCHC in community initiatives promoting child health and wellness
Contribute to advancing JPCHC's mission of accessible, inclusive care for all
MD or DO degree with Board Certification or Board Eligibility in Pediatrics
Active Indiana medical license or ability to obtain one
Commitment to serving underserved pediatric populations
Strong communication skills and team-based mindset
Leadership experience or interest strongly preferred
Experience in FQHC or community health settings highly desirable
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