- Evolent (Indianapolis, IN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Centene Corporation (Indianapolis, IN)
- …Performs other duties as assigned + Complies with all policies and standards We are seeking a Clinical Review Nurse - Concurrent Review to join our team! ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services...Compact State License + Post Acute Care Experience + Clinical Review Experience + Problem Solving Skills… more
- Fresenius Medical Center (Noblesville, IN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Elevance Health (Indianapolis, IN)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...management experience and requires a minimum of 2 years clinical , utilization review , or managed care experience;… more
- International Medical Group (Indianapolis, IN)
- …suggesting new ideas and seeking process improvements. + Judgment - use of good clinical judgment in resolving questions of medical necessity as it relates to ... As one of the world's top International Medical Insurance companies, IMG helps individuals and companies...of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between… more
- Humana (Indianapolis, IN)
- …guidance where needed. Follows established guidelines/procedures. **KEY ACCOUNTABILITIES** + Review medical documentation, obtain additional information that may ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals....TRICARE, all HGB policies and procedures as well as medical necessity review criteria and privacy requirements… more
- Humana (Indianapolis, IN)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Cardinal Health (Indianapolis, IN)
- …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
- BioLife Plasma Services (Indianapolis, IN)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife ... results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works...Medical Support Specialist + Two years in a clinical or hospital setting **More about us:** At Takeda,… more
- State of Indiana (Indianapolis, IN)
- …service providers to facilitate the delivery of health and development services. + Review medical records and provides professional medical opinions and ... of where they live, learn, work, or play. Role Overview: The Chief Nurse Consultant serves as the Immunization Division's clinical subject matter expert… more
- BioLife Plasma Services (Indianapolis, IN)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- Elevance Health (Indianapolis, IN)
- … necessity. + Extrapolates and summarizes medical information for medical director, consultants and other external review . + Prepares recommendations ... ** Nurse Appeals** **Hybrid 1:** This role requires associates... Appeals** is responsible for investigating and processing and medical necessity appeals requests from members and providers. **How… more
- Datavant (Indianapolis, IN)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- Highmark Health (Indianapolis, IN)
- …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient… more
- Elevance Health (Indianapolis, IN)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... in different states; therefore Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope… more
- Surgery Care Affiliates (Carmel, IN)
- …do it. Each decision we make is rooted in seven core values: + Clinical quality + Integrity + Service excellence + Teamwork + Accountability + Continuous improvement ... package to support your health, well-being, and financial future. Our offerings include medical , dental, and vision coverage, 401k plan with company match, paid time… more
- Lilly (Indianapolis, IN)
- …make life better for people around the world. **Purpose:** The Case Management Medical Review Scientist is responsible for conducting comprehensive medical ... related duties that might be required for the role/position. Medical review of ICSRs + Conduct comprehensive...degree, such as: DVM, PharmD, PhD, MSN with advanced clinical specialty ( Clinical Nurse Specialist/… more
- Lilly (Indianapolis, IN)
- …coaching by providing timely and constructive feedback to co-workers, others on the clinical medical team, in the spirit of development, increased team ... to make life better for people around the world. ** Clinical Research Scientist - Medical Affairs Allergy,...of other meetings with health care professionals. + Support medical information associates in preparation and review … more
- Lilly (Indianapolis, IN)
- …forms, and clinical study reports. + Supervise and participate in medical monitoring activities, including data review , safety assessments, and protocol ... health/ medical /scientific graduate degree such as, PharmD, PhD, MSN with advanced clinical specialty ( Clinical Nurse Specialist/ Nurse Practitioner) +… more
- CenterWell (Indianapolis, IN)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more