- Elevance Health (Indianapolis, IN)
- **Diagnosis Related Group Clinical Validation Auditor-** **Registered Nurse ** **Location:** This position will work a hybrid model (remote and office). Ideal ... miles of one of our PulsePoint locations. The **Diagnosis Related Group Clinical Validation Auditor** is responsible for auditing inpatient medical records to ensure… more
- Elevance Health (Indianapolis, IN)
- ** Nurse and CPC - Clinical Fraud...opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records ... locations. **Hybrid Workplace Strategy:** 1-2 days in office per week The ** Clinical Fraud Investigator II** is responsible for identifying issues and/or entities… more
- Fresenius Medical Center (Indianapolis, IN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Elevance Health (Indianapolis, IN)
- …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
- Elevance Health (Indianapolis, IN)
- …Provider Finder and follows up with provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles referrals for ... specialty care. + Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for… more
- Elevance Health (Indianapolis, IN)
- …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
- Elevance Health (Indianapolis, IN)
- …care management or case management experience and requires a minimum of 2 years clinical , utilization review , or managed care experience; or any combination of ... **Medical Management Nurse ** **Federal Employee Program - FEP** , a...judgment, critical thinking, and holistic assessment of a member's clinical presentation to determine whether to approve requested service(s)… more
- CenterWell (Indianapolis, IN)
- …teamwork and providing a positive and welcoming environment for all. Responsibilities: The Nurse Practitioner (NP) works in our team-based care environment. We are a ... team consists of doctors, advanced practice professionals, Pharm D, Care Coach Nurse , MA, Behavioral health specialist, Quality based Coder, Referral Coordinator and… more
- Intermountain Health (Indianapolis, IN)
- …+ Current RN license in state of practice. + Two years of hospital floor clinical nursing experience and/or Nurse Care Management experience. + Able to multitask ... **Job Description:** Full Time, Monday-Friday 08:00-17:00 PST. The nurse care manager works collaboratively with physicians and other members of the health care team… more
- Humana (Indianapolis, IN)
- …that supports the goal to put health first? The Prior Authorization, Registered Nurse , RN, Intern will review prior authorization requests for appropriate care ... services using clinical judgment and refers to internal stakeholders for review depending on case findings. + Educates providers on utilization and medical… more
- Lincoln Financial Group (Indianapolis, IN)
- …Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible ... claims. In this role you will act as a clinical resource for Group Protection benefit specialists and claim...for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state… more
- BioLife Plasma Services (Indianapolis, IN)
- …hundreds of thousands of people with rare and complex diseases. As a Plasma Center Nurse , you get to know our donors while working in a modern, fast-paced, yet ... Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary… more
- Fresenius Medical Center (Indianapolis, IN)
- **PURPOSE AND SCOPE:** The registered professional nurse (CAP RN 1) position is an entry level designation into the Clinical Advancement Program for Registered ... months from date of hire. + Performs ongoing, systematic review and analysis of dialysis data for Home Therapy...Patient Care Technicians/LPNs as a Team Leader or designated Nurse in charge, after the following: + Successful completion… more
- Highmark Health (Indianapolis, IN)
- …Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** The Registered Nurse assesses human responses and plans, implements and evaluates nursing care ... for individuals or families for whom the nurse is responsible. The Registered Nurse is...in on-going interdisciplinary communication specific to each patient with review of patient status and plan of care. +… more
- BioLife Plasma Services (Greenwood, IN)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Fresenius Medical Center (Indianapolis, IN)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN, for a limited period of time, and ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Community Health Network (Indianapolis, IN)
- Registered Nurse (RN) Case Manager - North Job Ref 2500061 Category Nursing Job Family Case Manager Department Case Management Schedule Full-time Facility Community ... has a full-time RN Case Manager position available. The Registered Nurse Case Manager is responsible for the assessment, planning, implementation, coordination,… more
- Help at Home (Indianapolis, IN)
- …**_Job Summary:_** The Nurse Manager, under the direct supervision of the Clinical Leader, will be responsible for managing all clinical processes in ... and mentor RN Case Managers + Evaluate, monitor and review all productivity metrics and KPI's that have been...survey readiness and escalate any potential concerns to the Clinical Leader **_Education and Experience:_** + Graduate of an… more
- Elevance Health (Indianapolis, IN)
- …reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines.** + Collaborates with healthcare providers, and ... Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners… more
- CenterWell (Indianapolis, IN)
- …Coordination and under established performance criteria. This is a work-from-home telephonic nurse position The Clinical Care Coordinator helps to ensure optimal ... regarding Home Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services + Participates in special… more