- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied… more
- Humana (Indianapolis, IN)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination,… more
- Humana (Indianapolis, IN)
- …work hours and hard-wired, high-speed internet service is required for this position --_ The Utilization Management Nurse 2 helps to ensure fully ... Minimum of associate degree in nursing + Licensed Registered Nurse (RN) in a compact state with no disciplinary... to 3 years of home health experience and/or utilization management experience + Experience in a… more
- Humana (Indianapolis, IN)
- …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work… more
- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative II** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within ... 50 miles of one of our PulsePoint locations. The ** Utilization Management Representative II** will be responsible...given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care. +… more
- CenterWell (Avon, IN)
- …driver's license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... Sign on Bonus available Hybrid Position-3 days at the Avon Office and 2 days remote** + Develops, plans, implements, analyzes, and organizes clinical operations for… more
- Humana (Indianapolis, IN)
- …Previous Medicare/Medicaid experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG or Interqual ... goal to put health first? The Prior Authorization, Registered Nurse , RN, Intern will review prior authorization requests for...review depending on case findings. + Educates providers on utilization and medical management processes. + Enters… more
- Intermountain Health (Indianapolis, IN)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. + Advocates, educates and coaches… more
- Elevance Health (Indianapolis, IN)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Ascension Health (Indianapolis, IN)
- …areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revise assignments daily to ... **Details** + **Department:** Case Management + **Schedule:** Full time, Mon-Fri days, occasional...One or more of the following required: + Registered Nurse credentialed from the Indiana Board of Nursing obtained… more
- Ascension Health (Indianapolis, IN)
- …Experience: + 5 years of experience required. + 10 years of experience preferred. + 2 years of leadership or management experience required. + 5 years of ... of assigned areas to best determine the allocation and utilization of services and budgets appropriately according to strategic...One or more of the following required: + Registered Nurse credentialed from the Indiana Board of Nursing obtained… more
- Community Health Network (Indianapolis, IN)
- …Ref 2408576 Category Nursing Job Family Case Manager Department Case Management Schedule Part-time Facility Community Hospital North 7150 Clearvista Drive ... of care to ensure quality patient outcomes and appropriate utilization of health care services. The Case Manager is...required. - Master's Degree in Social Work required. - 2 + years of inpatient, outpatient, or home-base social… more
- Wellpath (Indianapolis, IN)
- …the organization's Code of Conduct. + Demonstrates knowledge of risk management , clinical precautions, infection control, fall prevention, utilization of ... Graduation from an accredited School of Nursing Experience + 2 years of supervisory experience in an acute setting...+ Have and maintain current licensure as a Registered Nurse within the state of employment. + Obtain and… more