- Humana (Indianapolis, IN)
- …health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral health ... Management experience. The Utilization Management Behavioral Health Nurse completes...Qualifications** + Minimum of Associate's Degree in Nursing + Registered nurse with active Compact Licensure and… more
- Humana (Indianapolis, IN)
- …**Preferred Qualifications** + Expertise on NCQA accreditation standards, especially related to Utilization Management and/or Behavioral Health. + Detailed ... years of experience in NCQA Health Plan Accreditation and/or Utilization Management + Experience compiling NCQA File...and Reporting + Working knowledge using Power BI + Registered Nurse or Behavioral Health… more
- McLaren Health Care (Indianapolis, IN)
- We are looking for a Utilization Management , RN - IN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of ... Inc. at https://www.mdwise.org/ **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
- Prime Healthcare (Bloomington, IN)
- …work experience post-graduation of an accredited school of nursing and a current state Registered Nurse license. + Grandfathered prior to April 1, 2015. Minimum ... Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities Responsible for the quality and resource management of all patients that are admitted to the… more
- Elevance Health (Portage, IN)
- …or ask you for payment as part of consideration for employment. **Manager I Case Management , LTSS ( RN / LCSW)** + Job Family: BSP > Program/Project + Type: ... which Indiana members' needs are identified, including physical health, behavioral health, and social services for older adults, LTSS...in a managed care setting preferred. LCSW, LMHC, or RN license is highly preferred. Case Management … more
- Elevance Health (Beech Grove, IN)
- …or ask you for payment as part of consideration for employment. **LTSS Service Coordinator - RN ** + Job Family: MED > Licensed Nurse + Type: + Date Posted:Mar ... per week in-person with patients, members or providers The **LTSS Service Coordinator- RN ** is responsible for overall management of member's case within the… more
- Elevance Health (Indianapolis, IN)
- … with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, ... of consideration for employment. **Managed Care Coordinator Clinician Non RN ** + Job Family: MED > Licensed/Certified - Other...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- BrightSpring Health Services (Mishawaka, IN)
- …Education: Degree from an accredited school of nursing Qualifications:* Must be a Licensed Registered Nurse ( RN ) in good standing and currently licensed by ... all nursing personnel, and ensure care and services are coordinated with behavioral and programmatic staff in partnership with the Executive Director. The Director… more
- Universal Health Services (Jeffersonville, IN)
- … sciences or Diploma or Associate Degree in Nursing from an accredited school as a Registered Nurse or LPN. Experience: A minimum of one (1) year direct clinical ... to our in-patient services, we offer out-patient programs as well. The Utilization Review Coordinator is responsible for executing the UR function, which includes… more
- Elevance Health (Beech Grove, IN)
- …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... - CLINICIAN** is working under the direction/supervision of an RN , with overall responsibility for the member's case, as...health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Elevance Health (Indianapolis, IN)
- …LTSS/IDD), behavioral health or physical health needs. + Submits utilization /authorization requests to utilization management with documentation ... a risk is identified related to the members LTSS, physical or behavioral health supports (including, but not limited to, potential for high-risk complications).… more
- Elevance Health (Indianapolis, IN)
- …program in which Indiana members' needs are identified, including physical health, behavioral health, and social services for older adults, LTSS populations and ... and oversees program operations in support of corporate and health plan management . + Directs and collaborates with functional managers to develop and implement… more
- Parkview North Hospital (Fort Wayne, IN)
- Summary Coordinates, verifies, negotiates alternatives and manages the care of Parkview Behavioral Health (PBH) patients to facilitate the achievement of quality and ... group. Participates in quality improvement and evaluation processes related to the management of care. Provides mentoring with staff in understanding and working in… more