- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative II** **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 II** will be responsible...provider on referrals given. + Refers cases requiring clinical review to a nurse reviewer; and handles… more
- Elevance Health (Indianapolis, IN)
- Job Description **Title: Utilization Management Representative I** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... 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
- Elevance Health (Indianapolis, IN)
- …schedule.** **Build the Possibilities. Make an Extraordinary Impact.** The **Medical Management Nurse ** is responsible for the review of the most complex or ... **Be Part of an Extraordinary Team** **Medical Management Nurse ** **Location: Remote-** Candidates must...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- Elevance Health (Indianapolis, IN)
- **Medical Management Nurse ** **Federal Employee Program - FEP** , a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, ... pm (EST) shift rotation twice a month.** The **Medical Management Nurse ** is responsible for reviewing the...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… 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
- Elevance Health (Indianapolis, IN)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... required. **Preferred Skills, Capabilities, and Experiences** **:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… 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
- Evolent (Indianapolis, IN)
- …for operational performance of physician, nursing, and shared services staff in the utilization management value chain + Owns clinical rationale for ... point of responsibility for all clinical operations inclusive of nurse , physician, and shared services performance. and core work...utilization management decisions made by all clinical staff + Ensures… more
- Ascension Health (Indianapolis, 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, occasional...One or more of the following required: + Registered Nurse credentialed from the Indiana Board of Nursing obtained… more