- Parexel (Indianapolis, IN)
- **Job Title:** Data Management Lead (Medical Affairs) - Oncology **Location:** Fully Remote (US based) Must be able to accommodate West Coast hours. **About Us:** At ... solutions. We are seeking a dynamic and experienced Data Management Lead to join our team. If you have...practices like version control and literate programming. + BSN, RN , RPh, Pharm D, PA, MPH, or other applicable… more
- State of Indiana (Indianapolis, IN)
- Utilization Management Manager Date Posted: Nov 1, 2025 Requisition ID: 462259 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling career ... care and their communities. Role Overview: The role of Utilization Management Manager oversees the integration of...and clinical criteria evaluations.They will possess a current unrestricted RN license from the State of Indiana; a minimum… more
- Humana (Indianapolis, IN)
- …community and help us put health first** Full-Time, Remote Telephonic opportunity The Utilization Management Nurse 2 utilizes clinical nursing skills to ... 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… more
- CVS Health (Indianapolis, IN)
- …+ Active and good standing Arizona clinical and/or counseling license, specifically RN ( Registered Nurse ), LPC (Licensed Professional Counselor), LAC ... experience working within the mental health system. + Previous experience with utilization management . + Ability to collaborate with various internal… 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...skills to make an impact** **Required Qualifications** + **Licensed Registered Nurse ( RN )** in the… more
- CVS Health (Indianapolis, IN)
- …active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include weekends, ... all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and...**Required Qualifications** - 2+ years of experience as a Registered Nurse in adult acute care/critical care… 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...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Indianapolis, IN)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Indianapolis, IN)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- CVS Health (Indianapolis, IN)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… 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 (Noblesville, IN)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... of education and experience. + Graduate of an accredited School of Nursing ( RN ). + Current appropriate state licensure. **EXPERIENCE AND SKILLS:** + Required: + 6+… more
- Highmark Health (Indianapolis, IN)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Elevance Health (Indianapolis, IN)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... ** Nurse Reviewer I** **Virtual:** This role enables associates...required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding,… 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
- CVS Health (Indianapolis, IN)
- …+ 5-7 years of regulatory and/or clinical audit experience. + Experience in medical management , including Utilization Management (UM) and Case Management ... accreditation processes, and NCQA standards. + Licensed clinical professional ( RN preferred). + Excellent analytical, organizational, and communication skills. +… more
- Evolent (Indianapolis, IN)
- …responsible for support and assistance for all cardiology administrative and clinical utilization management and quality improvement functions under the auspices ... in a regulatory role (preferred). **LICENSE/CERTIFICATION:** Current, unrestricted state PA or RN /NP license in medicine or required specialty. Of a PA, obtaining a… more
- Elevance Health (Indianapolis, IN)
- …required by law. The ** Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care needs ... ** Nurse Case Manager II** **Hours: Monday - Friday...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… 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, ... sit on-site at our Avon, IN branch location.** The ** RN Clinical Manager** coordinates and oversees all direct care...School of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR.… more
- Elevance Health (Indianapolis, IN)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
