- Prime Therapeutics (Indianapolis, IN)
- …every decision we make. **Job Posting Title** Senior Project Solution Manager ( Utilization Management ) - Remote **Job Description Summary** Responsible ... and summarizing progress of projects. Prepares reports for upper management regarding status of project. Familiar with a variety...+ For clinical related roles, clinical licensure (eg, LPN, RN , LCSW, LMSW) is preferred. + 7+ years of… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) with compact… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Compliance Utilization Management Nurse 2 reviews utilization management ... rotating schedule. (about 2 holidays per year) The Compliance Utilization Management Nurse 2 ensures...make an impact** **Required Qualifications** + Active unrestricted Licensed Registered Nurse , ( RN ), in your… more
- McLaren Health Care (Indianapolis, IN)
- …as the member advocate with emphasis on education regarding managed care, disease management and PCP treatment plans. Monitors member's utilization patterns for ... We are looking for a Case Manager, RN to join us in leading our organization...services. + Two(2)yearsclinicalnursingexperience. + One (1) year previous case management or utilization review experience. **Preferred:** +… more
- Elevance Health (Indianapolis, IN)
- …and Experiences:** + Home health experience preferred. + 1 year of Utilization Management experience preferred. + Multi-State/Compact Nursing License strongly ... **Wound Care UM RN ** **Location:** Remote , within 50 miles...wound care. + Promotes healing and decrease home care utilization . + Responsible for certification determinations and sending written… more
- Sharecare, Inc. (Indianapolis, IN)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager....will follow company policy to transfer call to an RN or appropriate colleague when member needs are outside… more
- Marriott (Indianapolis, IN)
- …Information** Nurse CARE Manager (CARE - Coordinated Action and Response) Registered Nurse license required **Job Number** 24069165 **Job Category** Finance ... Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization ...informed **Education or Certification** + Must be a licensed registered nurse + Certification as an occupational… 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 ... of business development & growth, achievement of key performance indicators, management of nursing performance and staff development. Responsibilities * Oversees and… more
- Centene Corporation (Indianapolis, IN)
- … or data reporting and evaluation. Experience working in managed care, utilization management , case management , or quality improvement preferred. ... provider and member satisfaction + Serve as a resource and liaison on utilization , quality improvement, and case management activities + Partner with various… more
- Humana (Indianapolis, IN)
- …products including Word, Excel and Outlook **Preferred Qualifications** + Appeals/ Utilization Review/Quality Management experience + Previous claims experience ... community and help us put health first** The Appeals Nurse 2 resolves clinical complaints and appeals. The Appeals...are currently living in Puerto Rico. + Active unrestricted RN license + 3 years of clinical RN… more
- Elevance Health (Indianapolis, IN)
- **Senior Investigator (Investigator Sr)** _Location: This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles of one ... of business and/or state. + May interface internally with Senior level management and legal department throughout investigative process. + May assist in training… more