• Utilization Management Review…

    Humana (Indianapolis, IN)
    …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ... community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the coordination,… more
    Humana (08/22/24)
    - Save Job - Related Jobs - Block Source
  • Utilization Review Clinician - Behavioral…

    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 ... Analyzes BH member data to improve quality and appropriate utilization of services + Provides education to providers members...of an Accredited School Nursing or Bachelor's degree and 2 - 4 years of related experience. License to… more
    Centene Corporation (08/29/24)
    - Save Job - Related Jobs - Block Source
  • Enterprise Utilization Clinical…

    Humana (Indianapolis, IN)
    …**Preferred Qualifications** + Registered Nurse + Experience in Medicare Utilization Management + Project Management Professional (PMP) certification ... are addressed. They will work closely with established functions inside utilization management (Medical Director, clinician decision making teams, quality… more
    Humana (09/04/24)
    - Save Job - Related Jobs - Block Source
  • Telephonic Nurse Case Manager II

    Elevance Health (Indianapolis, IN)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
    Elevance Health (09/06/24)
    - Save Job - Related Jobs - Block Source
  • Telephonic Nurse Case Manager II

    Elevance Health (Indianapolis, IN)
    …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
    Elevance Health (09/06/24)
    - Save Job - Related Jobs - Block Source
  • Compliance Professional 2

    Humana (Indianapolis, IN)
    …ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, Durable ... caring community and help us put health first** The Compliance Professional 2 ensures compliance with governmental requirements. The Compliance Professional 2 more
    Humana (08/13/24)
    - Save Job - Related Jobs - Block Source
  • RN Manager, Case Management

    Ascension Health (Carmel, IN)
    …areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revise assignments daily to ... **Details** + **Department:** Case Management + **Schedule:** Full time, Mon-Fri, Days +...One or more of the following required: + Registered Nurse credentialed from the Indiana Board of Nursing obtained… more
    Ascension Health (09/05/24)
    - Save Job - Related Jobs - Block Source
  • RN Hospital Bill Audit/Appeal Lead

    Elevance Health (Indianapolis, IN)
    …Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation ... responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment… more
    Elevance Health (09/06/24)
    - Save Job - Related Jobs - Block Source
  • Case Manager- Licensed MSW- ED- North

    Community Health Network (Indianapolis, IN)
    …Ref 2404976 Category Nursing Job Family Case Manager Department Case Management Schedule Part-time Facility Community Hospital North 7150 Clearvista Drive ... Shift Day Job Hours 10:00 am - 10:30 pm, 2 shifts per week **Join Community** Community Health Network...of care to ensure quality patient outcomes and appropriate utilization of health care services. The Case Manager is… more
    Community Health Network (07/18/24)
    - Save Job - Related Jobs - Block Source
  • Field Clinical Specialist - Indianapolis, IN,…

    Edwards Lifesciences (Indianapolis, IN)
    …impact by ** + Working independently in the areas of valve crimping, case management , pre-case planning, post-case management , 3 Mensio management , Therapy ... implementing growth strategies within focused accounts in partnership with Sales Management . + Developing clinical champions among current and potential customers… more
    Edwards Lifesciences (09/06/24)
    - Save Job - Related Jobs - Block Source