- Elevance Health (Indianapolis, IN)
- ** Nurse Appeals ** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing ... employment, unless an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
- Evolent (Indianapolis, IN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- Cognizant (Indianapolis, IN)
- …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... . Maintain working knowledge of applicable health insurers' internal claims, appeals , and retro-authorization as well as timely filing deadlines and processes.… more
- Cummins Behavioral Health Systems Inc. (Avon, IN)
- …organization, Cummins is your kind of place. * If being part of a learning organization appeals to you, get in touch with us. * If you seek an employer with ethical ... in multiple counties throughout central and west central Indiana. The Advanced Practice Nurse , under the supervision of a Staff Psychiatrist, will augment our staff… more
- Sharecare (Indianapolis, IN)
- …enrollment / new hire plan selection, claims issues, ID card issues, grievances/ appeals , utilization management (UM) status, including but not limited to medical, ... 3rd parties for: + Claims adjustments + Grievances and appeals submissions + Utilization management intake or status +...and second opinion. + Referring members to Clinical Advocates ( Nurse ) for conditions that require clinical care and case… more
- CVS Health (Indianapolis, IN)
- …in non-compact states as needed. + 5+ years of acute experience as a Registered Nurse + 3+ years of Utilization Management experience + 3+ year(s) of Appeals ... experience in Utilization Management + Must have experience using MS Office + Must be willing to work holiday rotation annually, up to 2 per year + Utilization Management work schedules will include weekends, holidays, and evening hours rotation. **Preferred… more