- Elevance Health (Indianapolis, IN)
- ** Nurse Appeals ** **Location: Indiana** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... employment, unless an accommodation is granted as required by law. The ** Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
- Elevance Health (Indianapolis, IN)
- ** Nurse Appeals RN-Quality of Care** **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, ... employment, unless an accommodation is granted as required by law._ The ** Nurse Appeals ** is responsible for investigating and processing and medical necessity … more
- Evolent (Indianapolis, IN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Specialty Appeals Team offers candidates the opportunity to make a meaningful impact as part of ... a highly trained dedicated team focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and… more
- State of Indiana (Indianapolis, IN)
- Appeals & Eligibility Specialist Date Posted: Jan 9,...requirements at 42 CFR 483.430, or - A registered nurse in Good Standing with the State of Indiana ... plus one year's experience in human services; or- A bachelor's degree in social work, psychology, sociology, counseling, gerontology, or nursing; or health and human services or a bachelor's degree in any field plus a minimum of two years' full-time… more
- Cummins Behavioral Health Systems Inc. (Avon, IN)
- …organization, Cummins is your kind of place. * If being part of a learning organization appeals to you, get in touch with us. * If you seek an employer with ethical ... in multiple counties throughout central and west central Indiana. The Advanced Practice Nurse , under the supervision of a Staff Psychiatrist, will augment our staff… more
- International Medical Group (Indianapolis, IN)
- …outpatient management of assistance cases. + Knowledge of the Non-certification process and Appeals process including logs and time frames. + Participate in the on ... as assigned. QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing direct patient care… more
- Centene Corporation (Indianapolis, IN)
- …optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing complex cases and ... medical necessity appeals . + Participates in provider network development and new...a Psychiatrist or a board certified Psychiatric Mental Health Nurse Practitioner or Clinical Nurse Specialist with… more