- 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
- CVS Health (Indianapolis, IN)
- …administration of the utilization /benefit management function. Required Qualifications + Registered Nurse in state of residence. + 3+ years of Nursing ... experience. Preferred Qualifications + Prior authorization utilization management /review experience preferred Outpatient Clinical experience. + Knowledge of… more
- CVS Health (Indianapolis, IN)
- …both verbal and written. **Required Qualifications** + 2+ years of experience as a Registered Nurse in adult acute care/critical care setting. + Must have active ... current and unrestricted RN licensure in state of residence. + Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and… more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The SNF Utilization Management Nurse uses clinical knowledge, communication skills, and ... where needed. Follows established guidelines and procedures. The SNF Utilization Management Nurse uses clinical...an impact** **Required Qualifications** + Compact licensure + Licensed Registered Nurse (RN) in the (appropriate state)… 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
- 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
- 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
- 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
- Zurich NA (Indianapolis, IN)
- …Degree and 7 or more years of experience in the Nursing areaAND + Registered Professional Nurse license in residential area and in operational national/local ... + Experience in development and implementation of cost containment programs + Case management , utilization review, catastrophic or disability experience + 5 or… more
- Fresenius Medical Center (Shelbyville, 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
- 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
- Community Health Network (Indianapolis, IN)
- …Nursing (RN), Maternity East Job Ref 2502532 Category Nursing Job Family Registered Nurse Department Maternity Services Schedule Full-time Facility Community ... is required within 5 years of assuming the role. + Licensed as a Registered Nurse by the Indiana Professional Licensing Agency is required. + Certification… more
- Community Health Network (Indianapolis, IN)
- …is required within 5 years of assuming the role. + Licensed as a Registered Nurse by the Indiana Professional Licensing Agency is required. + Certification ... delivered - and we couldn't do it without you. **Make a Difference** The Nurse Manager position will oversee Progressive Care (PCU) at Community Hospital North. This… more
- Highmark Health (Indianapolis, IN)
- …Master's degree in Business or Clinical field **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse (RN) or Pharmacist (Pharm D) or Physician Assistant ... **SKILLS** + Deep Clincal Expertise -extensive knowledge of clinical, quality, care, utilization , high-cost claim, and population health management . Must be a… more