- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management RN, to join us in leading our organization forward. McLaren Integrated HMO Group (MIG) is a fully owned subsidiary of ... Inc. at https://www.mdwise.org/ . **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- Elevance Health (Indianapolis, IN)
- **Title: Utilization Management Representative II** **Location:** This position will work a remote model. 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)
- **Title: Utilization Management Representative I** **Location:** This position will work a remote model. Ideal candidates will live within 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)
- **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)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This is a...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… 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
- Highmark Health (Indianapolis, IN)
- …Highmark Health **Job Description :** **JOB SUMMARY** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Evolent (Indianapolis, IN)
- …years of direct clinical patient care + **Minimum one year of experience with Utilization Review (UM) in a managed care environment** + Cardiology and Oncology ... identifies and refers quality issues to the Senior Director of Medical Management or Medical Director. + Appropriately identifies potential cases for Care … more
- Teleflex (Indianapolis, IN)
- …territory. The incumbent is responsible for the growth of overall product utilization within their accounts including, but not limited to, selling the designated ... time in the field. * Facilitate sales growth by conducting physician, nurse , and technologist training and account in-servicing of dialysis access products. *… more