- 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, ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Fresenius Medical Center (Noblesville, IN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Highmark Health (Indianapolis, IN)
- …Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... + Experience in UM/CM/QA/Managed Care **LICENSES or CERTIFICATIONS** **Required** + United States Registered Nurse ( RN ) license + Delaware RN … more
- Humana (Indianapolis, IN)
- …guidelines/procedures. **Use your skills to make an impact** **Required Qualifications** + Active Licensed Registered Nurse ( RN ) in the state of Virginia or ... licensure + Previous Medicare/Medicaid experience a plus + Previous experience in utilization management , case management , discharge planning and/or home… more
- Elevance Health (Indianapolis, IN)
- …commute to the Elevance Health major office (PulsePoint) location listed above. The **Medical Management Nurse ** is responsible for review of the most ... **Medical Management Nurse ** **Office Location** : Atlanta,...experience and requires a minimum of 2 years clinical, utilization review , or case management … more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- Humana (Indianapolis, IN)
- …of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health knowledge and skills to ... of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within specific guidelines… more
- Guardian Life (Indianapolis, IN)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Sedgwick (Indianapolis, IN)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Medicare Compliance **We are growing and looking for nurses who have their ... clinical data; to complete complex submissions revisions/updates in preparation for Medicare review and act as an internal resource regarding Centers for Medicare &… more
- Elevance Health (Indianapolis, IN)
- …INDIANAPOLIS, IN.** **Schedule:** Monday through Friday 8:00 am - 5:00 pm. The **Medical Management Nurse ** is responsible for review of the most complex ... **Medical Management Nurse ** **Location:** This is a...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- Elevance Health (Indianapolis, IN)
- …or written review . **How you will make an impact:** + Coordinating utilization management process including appropriate use of UM Clinical Guidelines to ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Elevance Health (Indianapolis, IN)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... required. **Preferred Skills, Capabilities and Experiences** : + Experience in Utilization Management preferred. + Board Certified Behavioral Analyst (BCBA)… more
- Elevance Health (Indianapolis, IN)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... **Telephonic Nurse Case Manager II** **Location: This is a... Case Manager II** is responsible for performing care management within the scope of licensure for members with… 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