- 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)
- …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
- 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
- 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...using a keyboard **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
- 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
- Baylor Scott & White Health (Indianapolis, IN)
- **LOCATION:** Remote **SPECIALTY/DEPARTMENT:** Care Management : Case Management Utilization Management Appeals or grievances **SHIFT/SCHEDULE:** ... based on position type and/or level **Job Summary** A Registered Nurse in Nursing Professional Development Generalist...IN ONE OR MORE OF THE FOLLOWING SPECIALITIES:** **Case Management ** ** Utilization Management ** **Appeals or… more
- Evolent (Indianapolis, IN)
- …As a Clinical Reviewer, Nurse , you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts...and Preferred:** + Current, unrestricted state licensure as a Registered Nurse - **Required** + **California or Oregon… 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
- 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
- Humana (Indianapolis, IN)
- …experience + 6 or more years of clinical experience + 2 or more years of management experience + Licensed Registered Nurse (RN) in the (appropriate state) ... our caring community and help us put health first** The Associate Director, Utilization Management Nursing utilizes clinical nursing skills to support the… 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 will oversee the inpatient Oncology & STEM cell unit at Community Hospital… 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