- Kepro (Indianapolis, IN)
- …to being a vital partner for health solutions in the public sector. Acentra seeks a Utilization Management ( UM ) Nurse Clinical Reviewer - LPN/RN (Remote ... the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or concerns....or Bachelor's Degree Nursing Program. + 2+ years of Utilization Management ( UM ) experience from… more
- Evolent Health (Indianapolis, IN)
- …Quality/Compliance, Implementations. **What You Will Be Doing:** + Leadership of utilization management ( UM ) activities including design, implementation, ... the culture. **What You'll Be Doing:** As a Director, Utilization Management , you'll work with your managers,...training, appeals, and grievances for clients who have delegated UM . + Monitor all activities related to clinical review.… 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
- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates will live within 50 ... miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible...requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the identification and data… more
- Humana (Indianapolis, IN)
- … clinical levers, discharge planning, etc.) + Implement, manage, and support contractual Utilization Management & other clinical operations **Use your skills to ... + Five (5) plus years of experience in clinical areas such as: Utilization /Case Management , Claims Resolution, Contract/Market Management , and/or Healthcare… more