- Humana (Indianapolis, IN)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...appropriate courses of action. As a Utilization Management RN working on the OneHome/ Home Solutions… more
- CenterWell (Indianapolis, IN)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Evolent (Indianapolis, IN)
- …As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Veterans Affairs, Veterans Health Administration (Indianapolis, IN)
- …the Richard L. Roudebush VAMC, IN within the Primary Care service. The Licensed Practical Nurse works under the direction of an RN and reports to the primary care ... care plan for life. Responsibilities VA Careers - Licensed Practical Nurse : https://youtube.com/embed/Ae85IP1Oiz4 Total Rewards of a Allied Health Professional ROLE… more
- Evolent (Indianapolis, IN)
- …Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed ... medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care across the continuum… more
- Community Health Systems (Fort Wayne, IN)
- …health, or nursing home setting required + 2-4 years of care management experience preferred **Knowledge, Skills and Abilities** + Strong understanding of case ... **Job Summary** **Lutheran Hospital Registered Nurse Care Manager Weekend Premium** **FTE: .8 FTE...and overseeing discharge planning, transitions of care, and case management activities to ensure optimal patient outcomes. This role… more
- Fresenius Medical Center (Clarksville, IN)
- …and acting on adverse events and action thresholds. + Oversees facility's Home Therapies Program if applicable. + Accountable for compliance with all applicable ... and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely… more
- Fresenius Medical Center (Noblesville, IN)
- …Quality, and Technical Services departments. + Collaborates with or functions as the Home Therapies Program Manager to oversee the facility's Home Therapies ... Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. +… more
- Veterans Affairs, Veterans Health Administration (Vincennes, IN)
- … Management . Patient Assessments. Participation in interdisciplinary team process. Home care visits. Performing skilled nursing tasks (ie, blood draws, ... Marion VA Healthcare System is seeking a full-time Registered Nurse to serve in the role as Case Manager...serve in the role as Case Manager for the Home Based Primary Care Team. located in Vincennes, IN… more
- CenterWell (Avon, IN)
- …+ Two years as a Registered Nurse with at least one-year of management experience in a home care, hospice or equivalent environment. + Home ... : Avon, IN **This is not a remote or work-from- home position. This position requires you to sit on-site...clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates… more
- Sharecare (Indianapolis, IN)
- …/ new hire plan selection, claims issues, ID card issues, grievances/appeals, utilization management (UM) status, including but not limited to medical, ... + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status + Complex...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more