- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Manager , Utilization Management Nursing uses clinical knowledge, communication skills, and ... reports to monitor and track operational efficiency + Ability to perform case reviews. Properly documents utilization management activities and rationale for… 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 planning. ... Registered Nurse (RN) Case Manager - Community Heart &...of care to ensure quality patient outcomes and appropriate utilization of health care services. Responsible for supporting the… more
- International Medical Group (Indianapolis, IN)
- …efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the ... alternative care settings when appropriate. + Identify potential large case management cases by diagnosis, dollar amount and/or high...PREFERRED SKILLS + BSN Preferred + Minimum two years utilization review with a managed care or… more
- CenterWell (Avon, IN)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and… more
- Marriott (Indianapolis, IN)
- …with Claims department regarding case management. + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... from case management to meet jurisdictional needs. ** Utilization Review ** + Provide initial clinical ...nurse + Certification as an occupational health nurse and/or case manager (or, progress toward same) required… more
- Deloitte (Indianapolis, IN)
- Deloitte Technology-US (DT-US) PMO - Sr Project Manager As a Manager in the Deloitte Technology-US (DT-US) Office of the CIO (OCIO) PMO team, you will play a key ... Recruiting for this role ends on December 31, 2024. Work you'll do As a DT-US Manager , you will work directly with the DT-US PMO FSS or Enabling Area Leads to… more
- Elevance Health (Indianapolis, IN)
- …working with patients with a substance use disorder strongly preferred. + Strong utilization review experience within a facility preferred. Note: this role will ... services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with… more
- Elevance Health (Indianapolis, IN)
- …+ Licensure is a requirement for this position. + Previous experience in case management/ utilization management with a broad range of experience with complex ... may be asked to work in office as needed.** The **Behavioral Health Care Manager I** - **Indiana** is responsible for managing psychiatric and substance abuse or… more
- Merck (Indianapolis, IN)
- …is responsible to manage/oversee a team of CTCs(Clinical Trial Coordinator). As line manager the role is critical to continuously develop future talent by providing ... work across the different country operations roles (eg CRM(Clinical Research Manager ), CRA(Clinical Research Associate)- Manager , Partners, TA-Head, CRD and… more
- Elevance Health (Indianapolis, IN)
- …must be located in a state or territory of the United States when conducting a utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations and patient's office visits with providers and external physicians.… more
- Veterans Affairs, Veterans Health Administration (IN)
- …complex issues/situations unresolved by subordinates on a continuous basis through review of completed work and production goals achieved. Reviews administrative and ... complex determinations unresolved by subordinates on a continuous basis through review of completed work and assessment of results obtained. Recommends/makes… more
- Intrepid USA (Columbus, IN)
- …suggestions for changes in the plan of care to the client's physician and Case Manager + Prepares clinical records (initial evaluations - including OASIS, care ... modifications to the physician + Participates in the development, review , and updating of the care plan + Observes,...Participates as a member of the interdisciplinary team in case conferences and in planning and evaluating the total… more
- CenterWell (Indianapolis, IN)
- …+ Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and procedures + Human ... and keep records of criteria for admission to service, case assignments, and case management. + Represent...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Elevance Health (Indianapolis, IN)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.… more
- Elevance Health (Indianapolis, IN)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.… more