- Humana (Indianapolis, IN)
- …documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are ... a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the… more
- Lincoln Financial Group (Indianapolis, IN)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... Role at a Glance** We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position will be responsible for… more
- Centene Corporation (Indianapolis, IN)
- …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization offering competitive… more
- Elevance Health (Indianapolis, IN)
- **Anticipated End Date:** 2024-09-13 **Position Title:** Utilization Management Rep I **Job Description:** **Title: Utilization Management Representative ... 50 miles of one of our PulsePoint locations. The ** Utilization Management Representative I** will be responsible...and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible… more
- Humana (Indianapolis, IN)
- …and ad hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse (RN) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- 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
- Liberty Healthcare Corporation (Indianapolis, IN)
- Registered Nurses are encouraged to consider a new full-time Mortality Review Nurse Investigator position with Liberty Healthcare. Liberty Healthcare endeavors ... become an employment first state. As Liberty Healthcare's Mortality Review Nurse , the downstream impact of your... (RN). Experience in areas related to quality assurance, utilization review , clinical investigations, mortality review… more
- Elevance Health (Indianapolis, IN)
- …health insurance/benefits, medical management process, care management , and utilization review management strongly preferred. For candidates working ... Case Manager II** is responsible for the Case Management and Utilization Management of...Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts… more
- Community Health Network (Indianapolis, IN)
- …continuity of care and cost effectiveness through the integrating and functions of case management , utilization review and management and discharge ... Registered Nurse (RN) Case Manager - Community East Job...2403702 Category Nursing Job Family Case Manager Department Case Management Schedule Full-time Facility Community Hospital East 1500 North… more
- Elevance Health (Indianapolis, IN)
- …EST** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires… more
- Fresenius Medical Center (Indianapolis, IN)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN, for a limited period of time, and ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Fresenius Medical Center (Indianapolis, IN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Ascension Health (Carmel, IN)
- …specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and ... **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
- CenterWell (Avon, IN)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking...and reliable transportation. + Two years as a Registered Nurse with at least one-year of management … more
- Elevance Health (Indianapolis, IN)
- …**How you will make an impact:** + Develops, maintains and enhances the claims review process. + Assists management with developing unit goals, policies and ... Level:** Non- Management Exempt **Workshift:** **Job Family:** MED > Licensed Nurse Please be advised that Elevance Health only accepts resumes for compensation… more
- Cardinal Health (Indianapolis, IN)
- …for physician leaders and physician board regarding all areas of practice management and operations. This leader has primary responsibility to manage and drive ... will be needed in the following areas: practice operations, revenue cycle management , patient growth and practice marketing, value-based care, payor relations, EHR,… more