- Elevance Health (Indianapolis, IN)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- Evolent (Indianapolis, IN)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United States. Acts… more
- CVS Health (Indianapolis, IN)
- …it all with heart, each and every day. **Position Summary** The Quality Management Nurse (QM Nurse ) supports Aetna Better Health of Texas by ensuring compliance ... clinical expertise with quality improvement leadership, including clinical documentation review , Performance Improvement Projects (PIPs), ANE oversight, and policy… more
- BioLife Plasma Services (Indianapolis, IN)
- …hundreds of thousands of people with rare and complex diseases. As a Plasma Center Nurse , you get to know our donors while working in a modern, fast-paced, yet ... Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife Plasma Services is a subsidiary… more
- 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
- BioLife Plasma Services (Indianapolis, IN)
- …Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife Plasma Services is a subsidiary of ... determine donor eligibility to donate plasma, management of donor adverse events, review of laboratory test results, and donor notification of unsuitable test… more
- Humana (Indianapolis, IN)
- …and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and ... and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are varied and frequently require interpretation… more
- CVS Health (Indianapolis, IN)
- …medical necessity reviews. **Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in a hospital setting. + ... A Registered Nurse that holds an active, unrestricted license in their...levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred.… more
- Elevance Health (Indianapolis, IN)
- …as required by law. ** Must be an Indiana resident ** The **Medical Management Nurse ** is responsible for review of the most complex or challenging cases that ... Director on particularly peculiar or complex cases as the nurse deems appropriate. + May make recommendations on alternate...and requires a minimum of 2 years clinical, utilization review , or managed care experience; or any combination of… more
- Cognizant (Indianapolis, IN)
- …to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,...have to be considered** . Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization… more
- State of Indiana (Indianapolis, IN)
- Immunizations Nurse Consultant Date Posted: Nov 25, 2025 Requisition ID: 468858 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career with ... of where they live, learn, work, or play. Role Overview: The Chief Nurse Consultant serves as the Immunization Division's clinical subject matter expert providing… more
- Elevance Health (Indianapolis, IN)
- **Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role requires associates to be in-office 1 - 2 days ... opportunities for fraud and abuse prevention and control. + Review and conducts analysis of claims and medical records...Skills, Qualifications, and Experiences:** + Fraud and Abuse experienced Nurse with a CPC are highly desired. For candidates… more
- Elevance Health (Indianapolis, IN)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... the assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- Surgery Care Affiliates (Carmel, IN)
- …you join our team, they will. Responsibilities We are actively hiring for an Registered Nurse (RN) PreOp PACU. + Promote the mission, vision, and values of SCA . + ... to care. + Delegate tasks according to the state Nurse Practice Act (if applicable), state board of nursing...with other disciplines as needed. + Participate in quality review and performance improvement projects. + Participate in the… more
- International Medical Group (Indianapolis, IN)
- …of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the Insured, the ... QUALIFICATIONS + Current and active Nursing license - Registered Nurse + Minimum two years acute hospital-based experience providing...SKILLS + BSN Preferred + Minimum two years utilization review with a managed care or insurance company +… more
- Datavant (Indianapolis, IN)
- …+ 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or CDIP certification required + Must ... protected status. To learn more about our commitment, please review our EEO Commitment Statement here (https://www.datavant.com/eeo-commitment-statement) . Know Your… more
- Fresenius Medical Center (Indianapolis, IN)
- …to the Inpatient Program Manager, appropriately credentialed physician, patient hospital primary nurse and others as indicated. + Assesses patients pre, during and ... and hospital staff members to ensure effective and efficient treatments. Other: + Review and comply with the Code of Business Conduct and all applicable company… more
- Ascension Health (Indianapolis, IN)
- …is a_ _general posting_ _for the Medical Progressive Care Unit (MPCU)._ _We will review our open opportunities together and determine the best fit or invite you to ... date required. American Heart Association or American Red Cross accepted. + Registered Nurse credentialed from the Indiana Board of Nursing obtained prior to hire… more
- Ascension Health (Indianapolis, IN)
- **Details** _This is a_ _general posting_ _for the Burn ICU._ _We will review our open opportunities together and determine the best fit or invite you to our ... date required. American Heart Association or American Red Cross accepted. + Registered Nurse credentialed from the Indiana Board of Nursing obtained prior to hire… more
- Fresenius Medical Center (Noblesville, IN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... including efficient utilization of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and on-site state or… more