- PharmaCord (Jeffersonville, IN)
- …Bachelor's degree required; Master's degree is preferred Nurse line triage, Call Center Utilization Management , Call Center Case Management a plus Case ... management or Clinical Trial Nurse experience, a plus Previous personnel/team management experience is required, experience managing managers is a plus… more
- PharmaCord (Jeffersonville, IN)
- …Utilization Management , Call Center Case Management , a plus. Case management or Clinical Trial Nurse experience, a plus. Bachelor's degree ... our Talent Acquisition team immediately at ###@pharmacord.com As an Oncology Registered Nurse (RN) Case Manager you are responsible for contact with program patients… more
- PharmaCord (Jeffersonville, IN)
- …with relevant disease state experience preferred. Nurse line triage, Call Center Utilization Management , Call Center Case Management a plus. Case ... and resources. When you join the team as a Nurse Supervisor, you'll have the opportunity to make a...management or Clinical Trial Nurse experience, a plus. Bachelor's degree or higher strongly… more
- CVS Health (Indianapolis, IN)
- …And we do it all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- Humana (Indianapolis, IN)
- …help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Cognizant (Indianapolis, IN)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan ... Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced...care revenue cycle or clinic operations . Experience in utilization management to include Clinical … more
- Humana (Indianapolis, IN)
- …of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... determination of the appropriate courses of action. The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent… more
- CVS Health (Indianapolis, IN)
- …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
- Evolent (Indianapolis, IN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks are ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. Acts as a member advocate by… more
- Fresenius Medical Center (Evansville, IN)
- …requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory ... and FMS patient care and administrative policies as the clinical leader, has the authority to make daily decisions...the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member… more
- Fresenius Medical Center (Indianapolis, IN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... or chronic kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture of continuous learning… more
- Sharecare (Indianapolis, IN)
- …helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management Nurse is also responsible during ... for everyone. To learn more, visit www.sharecare.com . **Job Summary:** The Disease Management Nurse has the responsibility for supporting the goals and… more
- CVS Health (Indianapolis, IN)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- Trinity Health (Mishawaka, IN)
- …The inpatient **Certified Wound Ostomy Continency Consultant (CWOCN Consultant), Registered Nurse ** will provide clinical oversight and coordination for ... support and staff development activities that provide the bedside nurse with the knowledge, skills, and confidence to manage...and their family members to assist them in the management of their individual wound care needs. Ultimate responsibility… more
- Trinity Health (Mishawaka, IN)
- …by assignment. Minimum five (5) years of equivalent experience in health condition management in an adult acute care clinical setting with direct patient ... This is NOT a remote position.** **_About the job:_** The licensed Registered Nurse (RN) plans & provides professional nursing services & standards of practice in… more
- Highmark Health (Indianapolis, IN)
- …Degree in Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical , case/ utilization management and/or disease/condition management ... panel of members that range in health status/severity and clinical needs; and assesses health management needs...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… 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 role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum requirements:**… more
- Evolent (Indianapolis, IN)
- …team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and ... accomplishments. **What You Will Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Community Health Systems (Fort Wayne, IN)
- …huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate ... are available and properly utilized while maintaining cost-effective resource management . + Facilitates ongoing education and professional development for nursing… more
- Fresenius Medical Center (Anderson, 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
