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Weekend Utilization Review Jobs in Indiana (NOW HIRING)

TEEMA Group

RN Case Manager

Evansville, IN · On-site

$83K - $93K/yr

Day Shift (No weekends!) 💰 Pay: Competitive + Benefits Why This Role Stands Out Looking for a ... 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

RN Care Manager - NO Weekends | M-F Schedule | Evansville, IN 📍 Evansville, IN | Full-Time | Day ... Perform utilization review (UR) and payer communication * Support hospital goals: reduce LOS ...

UHS

UR Coordinator (PRN)

Kouts, IN · On-site

Experience in patient assessment, family motiviation, treatment planning and communication with external review organizations or comparable entities. • RN, LSW, LCSW license or equivalent. EEO ...

MISO

Manager Resource Utilization

Carmel, IN · On-site

$166K - $191K/yr

As MISO's Manager - Resource Utilization, you will lead a team at the center of critical ... For further information, please review the Know Your Rights notice from the Department of Labor.

MISO

Manager Resource Utilization

Carmel, IN · On-site

$166K - $191K/yr

Description As MISO's Manager - Resource Utilization, you will lead a team at the center of ... For further information, please review the Know Your Rights notice from the Department of Labor.

MISO Energy

Manager Resource Utilization

Carmel, IN · On-site

$166K - $191K/yr

Description As MISO's Manager - Resource Utilization, you will lead a team at the center of ... For further information, please review the Know Your Rights ( notice from the Department of Labor.

ScionHealth

Case Manager II PRN

Indianapolis, IN · On-site

Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise ...

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Weekend Utilization Review information

What does a typical weekend shift look like for a Utilization Review professional?

Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.

What is a Weekend Utilization Review job?

A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.

What are the key skills and qualifications needed to thrive in the Weekend Utilization Review position, and why are they important?

Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.

What are the most commonly searched types of Utilization Review jobs in Indiana? The most popular types of Utilization Review jobs in Indiana are:
What are popular job titles related to Weekend Utilization Review jobs in Indiana? For Weekend Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Weekend Utilization Review jobs in Indiana look for? The top searched job categories for Weekend Utilization Review jobs in Indiana are:
What cities in Indiana are hiring for Weekend Utilization Review jobs? Cities in Indiana with the most Weekend Utilization Review job openings:
Weekend Utilization Review jobs near you
Infographic showing various Weekend Utilization Review job openings in Indiana as of June 2026, with employment types broken down into 71% Full Time, and 29% Part Time. Highlights an 100% In-person job distribution.

Utilization Management Nurse

SIHO HOLDING INC

Columbus, IN

Other

Posted 29 days ago

Job description

Job Title:  Utilization Management Nurse
Reports To:  Manager of Utilization Management
Employment Type:  Full-Time, Exempt

Brief Description of Duties:    
This position is reserved for a licensed Registered Nurse who will perform the Utilization Management (UM) services for SIHO (and affiliated business lines’) members. This individual’s primary role is to ensure that health care services are administered with quality, cost effectiveness, and compliance to plan guidelines. By performing review of services prospectively, retrospectively, and throughout the episode of care, the UM nurse will make coverage determinations influencing how services are allocated to SIHO’s various member populations.  A candidate’s ability to perform quality reviews within strict efficiency standards is required for this position.  Key responsibilities are as follows:

  • Pre-service, concurrent, and post-service review for medical necessity of health care services utilizing enrollee medical records and established guidelines set by SIHO and/or state and federal (CMS) guidelines
  • Interaction with the member, health care provider, and/or other care team members to complete reviews in most time-efficient manner
  • Interaction with the SIHO Medical Director or external Medical Reviewers as needed to ensure proper medical necessity decisions are made in a timely manner
  • Appropriate documentation of the entire review process utilizing the established documentation system and desk procedures to guarantee accurate reporting metrics and data integrity
  • Complete case review and manage turnaround times to assure determinations are rendered within the contractual and regulatory turnaround times established by SIHO and CMS
  • Assist in problem resolution and provide guidance to members of the team and cohorts
  • Interpret and abide by organizational policies and procedures; review work regularly to ensure that policies and guidelines are appropriately applied
  • Act as a clinical resource to the department and other organization members for services pertaining to medical management, utilization review, and medical necessity 
  • Act and perform within the scope of professional nursing practice; display responsibility in supporting and participating in department strategies and efforts focused on quality improvement
  • Responsible for the early identification and assessment of members for inclusion in disease management or care management programs
  • Assist in the identification and reporting of Potential Quality of Care concerns and Fraud, Waste and Abuse incidents
  • Work as an interdisciplinary team member within Medical Management for all lines of business and commercial group plans
  • Show effective prioritization, efficiency and accuracy of work product in alignment with department goals.

Minimum Skills Requirement:

  • Registered Nurse with current, unrestricted license in primary state of employment (position may require additional licensing in other states as necessary)
  • Previous UM or Health Plan experience highly preferred
  • Desire to work in a fast-paced environment with focus on efficiency and attention to detail while maintaining quality
  • Self-directed organizational and prioritization skills, and independent time management skills required
  • Sound clinical background with experience in the clinical field
  • Excellent verbal and written communication skills
  • Microsoft Office Experience: Outlook, Word, Excel

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