- 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...**Required Qualifications** + **Must Reside in Indiana** + Licensed Registered Nurse in the state of Indiana… more
- 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
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure ... skills to make an impact** **Required Qualifications** + Active Registered Nurse license in a state that...one, (1), year of experience auditing and/or performing case management or utilization management chart… 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)
- **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...+ Minimum of associate degree in nursing + Licensed Registered Nurse (RN) in a compact state… more
- Healthfirst (IN)
- **Duties/Responsibilities:** + Oversees utilization management functions which include timely authorizations related to pre-certification, concurrent review, ... and reviews medical charts to obtain additional information required for appropriate utilization management and to solve complex clinical problems + Allocate,… 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
- 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
- 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
- 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)
- ** Registered Nurse Charge Cardiac Tele 5A** **Full time: .9 FTE (36 hours per week)** **Shift: days 7a-7p** **Welcome bonus eligible up to $35,000!** ... 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)
- …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 (Mishawaka, IN)
- …under the direction of the Facility Manager, Director of Nursing and/or Charge Registered Nurse , utilizing standard nursing techniques to assist the physician in ... on adverse events and action thresholds in collaboration with facility management . + Maintains integrity of medical records and other organization administrative… more
- Fresenius Medical Center (Gary, 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 (South Bend, 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)
- …Doing:** 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 ... Clinical Reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
- Community Health Systems (Fort Wayne, IN)
- …home health with excellent communication required + 2-4 years experience in case management or utilization management preferred **Knowledge, Skills and ... insurance and more **Job Summary** The Manager of Care Management is responsible for the development, planning, coordination and...and logical manner. **Licenses and Certifications** + RN - Registered Nurse - State Licensure and/or Compact… 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