- 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… 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 ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are… more
- Veterans Affairs, Veterans Health Administration (Fort Wayne, IN)
- Summary The Registered Nurse -PACT is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. ... customer satisfaction throughout the continuum of care. Responsibilities The Registered Nurse Patient Aligned Care Team (PACT)...and coaching on wellness, disease prevention, and chronic care management . The nurse will assist in directing… 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 ... + Perform medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital… more
- Trinity Health (Mishawaka, IN)
- …SUMMARY:** The inpatient **Certified Wound Ostomy Continency Consultant (CWOCN Consultant), Registered Nurse ** will provide clinical oversight and coordination ... support and staff development activities that provide the bedside nurse with the knowledge, skills, and confidence to manage...and their family members to assist them in the management of their individual wound care needs. Ultimate responsibility… more
- Trinity Health (Mishawaka, IN)
- …team approach This is NOT a remote position.** **_About the job:_** The licensed Registered Nurse (RN) plans & provides professional nursing services & standards ... national certification in one of the following: Certified Acute Care Virtual Registered Nurse (CAVRN), Acute/critical care nursing (CCRN), Certified Emergency … more
- Community Health Systems (Fort Wayne, IN)
- **Job Summary** **Lutheran Hospital Registered Nurse Care Manager Weekend Premium** **FTE: .8 FTE (32 hours per week)** **Weekend Premium included (one weekend ... to prioritize tasks in a dynamic environment. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required +… more
- Community Health Systems (Fort Wayne, IN)
- …for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required ... huddles. + Monitors patient flow, manages bed assignments, and optimizes resource utilization within the unit. + Conducts employee and patient rounding to evaluate… more
- Fresenius Medical Center (Indianapolis, IN)
- …staff training, equipment, physician and patient relations, cost containment, supply management , medical records, patient billing, OSHA and all company, state and ... quality of patient care, as defined by the quality goals, by working with management to ensure that policies and procedures are followed. + Assists with implementing… more
- Fresenius Medical Center (Clarksville, 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
- 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
- International Medical Group (Indianapolis, IN)
- …or tasks as assigned. QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing direct ... large case management cases by diagnosis, dollar amount and/or high utilization of medical services and refer those identified for large case management… more
- Evolent (Indianapolis, IN)
- …+ Performs other duties as assigned. **The Experience You'll Need (Required):** + Registered Nurse or Licensed Practical/Vocational Nurse with a current, ... Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are performed… more
- Community Health Systems (Fort Wayne, IN)
- …software systems, and data analysis tools. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required or ... is responsible for the planning, coordination, and oversight of care management services, including utilization review, discharge planning, and transitions of… more
- Elevance Health (Indianapolis, IN)
- …on relatively complex case types that do not require the training or skill of a registered nurse . Acts as a resource for more junior clinicians. **How you will ... Capabilities, and Experiences:** + Prior claims experience is strongly preferred. + Utilization Management experience is strongly preferred. + Health insurance… more
- CenterWell (Avon, 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
- CVS Health (Indianapolis, IN)
- …years of acute experience as a Registered Nurse - 1+ years of Utilization Management experience - Must have experience using MS Office suites - Must be ... year - Occasional travel less than 5% to complete audits/meetings - Utilization Management is a 24/7 operation and work schedules will include weekends,… more
- Highmark Health (Indianapolis, IN)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more
- Community Health Systems (Valparaiso, IN)
- **Offering Competitive Pay Rates!!** ** Registered Nurse (RN) Charge Full Time, Nights Position in the Emergency Department at Northwest Health - Valparaiso ... for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more
- Community Health Systems (Fort Wayne, IN)
- **Job Summary** Lutheran Hospital Registered Nurse Cardiac Tele 5A Full time: .9 FTE (36 hours per week) Shift: nights 7p-7a Welcome bonus eligible up to ... for addressing unit challenges and emergencies. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact State Licensure required… more