• Utilization Management

    CVS Health (Indianapolis, IN)
    …**EST or CST residents preferred due to region of members.** **As a UM Clinician Behavioral Health you will:** + Utilize clinical experience and skills in ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** + 3+ years of… more
    CVS Health (12/12/25)
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  • Utilization Review Clinician

    Centene Corporation (Indianapolis, IN)
    …28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive ... accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment… more
    Centene Corporation (12/06/25)
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  • LTSS Service Coordinator - RN Clinician

    Elevance Health (Darmstadt, IN)
    …an accommodation is granted as required by law._ The **LTSS Service Coordinator-RN Clinician ** is responsible for overall management of member's case within the ... and face-to-face functional assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral more
    Elevance Health (12/12/25)
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  • LTSS Service Coordinator- Clinician

    Elevance Health (Indianapolis, IN)
    …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... **LTSS Service Coordinator- Clinician ** **Schedule:** Monday-Friday 8am-5pm EST **Location** : Candidates...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
    Elevance Health (12/13/25)
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  • Payment Integrity Clinician

    Highmark Health (Indianapolis, IN)
    …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... itemized bills, and claims data to assure appropriate level of payment and resource utilization . It is also used to identify issues which can be used for education… more
    Highmark Health (11/14/25)
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