- 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
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** The Utilization Management (UM) Director, Clinical Strategy and Practice for Medicaid builds ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director, Clinical Strategy and Practice for… more
- Veterans Affairs, Veterans Health Administration (Marion, IN)
- …EDRP participants ineligible to apply. Responsibilities The Inpatient Mental Health (MH) Registered Nurse (RN) provides and leads the provision of competent, ... nurse independently provides patient-centered and recovery-oriented care, milieu management , and maintains self-awareness while caring for patients living with… 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 ... reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year...Pharmacy or Oncology.** **Preferred Qualifications** + 1+ years' Case Management experience or discharge planning, nurse navigator… more
- Healthfirst (IN)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, ... and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate,… more
- Community Health Network (Indianapolis, IN)
- Registered Nurse (RN) Case Manager - East Emergency Department Job Ref 2501140 Category Nursing Job Family Case Manager Department Case Management Schedule ... Case Manager position available in the Emergency Department. The Registered Nurse Case Manager is responsible for...cost effectiveness through the integrating and functions of case management , utilization review and management … more
- Trinity Health (Mishawaka, IN)
- …SUMMARY:** The inpatient **Certified Wound Ostomy Continency Consultant (CWOCN Consultant), Registered Nurse ** will provide clinical oversight and coordination ... 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
- Sharecare (Indianapolis, IN)
- …cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also responsible for early identification of those ... learn more, visit www.sharecare.com . **Job Summary:** The Clinical Registered Nurse has the responsibility for supporting...disease management program intervention guidelines. A Clinical Registered Nurse is supervised by an Operations… more
- Trinity Health (Mishawaka, IN)
- …quality care. This is NOT a remote position.** **_About the job:_** The licensed Registered Nurse (RN) plans & provides professional nursing services & standards ... national certification in one of the following: Certified Acute Care Virtual Registered Nurse (CAVRN), Acute/critical care nursing (CCRN), Certified Emergency … more
- Fresenius Medical Center (Mishawaka, IN)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- Fresenius Medical Center (Lebanon, IN)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Fresenius Medical Center (Noblesville, IN)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Preferred but not required: + 3+ years supervisory or project/program management experience. + Med/surg or ICU/CCU experience. **PHYSICAL DEMANDS AND WORKING… more
- Lincoln Financial (Indianapolis, IN)
- …as indicated **What we're looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license in the state where the ... We are excited to bring on a highly motivated Nurse Disability Consultant to our clinical organization. This position...Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's… more
- Community Health Systems (Fort Wayne, IN)
- …home health with excellent communication required + 2-4 years experience in case management or utilization management preferred **Knowledge, Skills and ... insurance and more **Job Summary** The Manager of Care Management is responsible for the development, planning, coordination and...and logical manner. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact… more
- United Therapeutics (Indianapolis, IN)
- …years of PAH nursing experience, including ICU and critical care of PAH patients + Registered Nurse (RN) - State Licensure and/or Compact State Licensure RN - ... make a difference. The Regional Field Director, RNS Program Management serves as a director of all clinical field...Registered Nurse - State Licensure and/or Compact… more
- Ascension Health (Indianapolis, IN)
- …off shift work + **Hospital:** Ascension St. Vincent + **Location:** Indianapolis, IN Registered Nurse in the State of Indiana. Bachelor's Degree. Leadership & ... utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revise...Registration: One or more of the following required: + Registered Nurse credentialed from the Indiana Board… more
- Humana (Indianapolis, IN)
- …**Key Functions:** **Strategic Planning and Implementation:** + Develop and implement utilization management strategies that align with organizational goals. + ... care. **Cost Containment:** + Identify opportunities for cost savings through effective utilization management practices. + Monitor and analyze utilization … more
- Ascension Health (Indianapolis, IN)
- …/ Certification / Registration: + One or more of the following required: + Registered Nurse credentialed from the Indiana Board of Nursing obtained prior to ... + Strong understanding of: + Discharge planning + Medicare/Medicaid regulations + Utilization review and management + Behavioral health and social determinants… more
- CenterWell (Indianapolis, IN)
- …license, auto insurance and reliable transportation. + Two years as a Registered Nurse with at least one-year of management experience in a home care, ... clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Community Health Systems (Fort Wayne, IN)
- **Job Summary** ** Registered Nurse Care Manager** **Part time: .6 FTE (24 hours per week)** **Days: 8a-8p** **Weekend Premium** **Welcome bonus eligible for up ... to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required +… more