- Prime Healthcare (Bloomington, IN)
- …and maintain current. #LI-AS2 Connect With Us! (https://careers-primehealthcare.icims.com/jobs/161307/ case - manager utilization - review ... to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity,...Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. + Five years acute… more
- Humana (Indianapolis, IN)
- …part of our caring community and help us put health first** The Manager , Utilization Management Nursing uses clinical knowledge, communication skills, and ... reports to monitor and track operational efficiency + Ability to perform case reviews. Properly documents utilization management activities and rationale for… more
- Community Health Network (Indianapolis, IN)
- …continuity of care and cost effectiveness through the integrating and functions of case management, utilization review and management and discharge planning. ... Registered Nurse (RN) Case Manager - Community Heart &...of care to ensure quality patient outcomes and appropriate utilization of health care services. Responsible for supporting the… more
- International Medical Group (Indianapolis, IN)
- …efficiency of the use of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between the ... alternative care settings when appropriate. + Identify potential large case management cases by diagnosis, dollar amount and/or high...PREFERRED SKILLS + BSN Preferred + Minimum two years utilization review with a managed care or… more
- CenterWell (Avon, IN)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and… more
- Marriott (Indianapolis, IN)
- …with Claims department regarding case management. + Collaborate with UNM on utilization review issues. + Refer catastrophic cases in coordination with claims ... from case management to meet jurisdictional needs. Utilization Review + Provide initial clinical ...nurse + Certification as an occupational health nurse and/or case manager (or, progress toward same) required… more
- Deloitte (Indianapolis, IN)
- Deloitte Technology-US (DT-US) PMO - Sr Project Manager As a Manager in the Deloitte Technology-US (DT-US) Office of the CIO (OCIO) PMO team, you will play a key ... Recruiting for this role ends on December 31, 2024. Work you'll do As a DT-US Manager , you will work directly with the DT-US PMO FSS or Enabling Area Leads to… more
- Intrepid USA (Columbus, IN)
- …suggestions for changes in the plan of care to the client's physician and Case Manager + Prepares clinical records (initial evaluations - including OASIS, care ... modifications to the physician + Participates in the development, review , and updating of the care plan + Observes,...Participates as a member of the interdisciplinary team in case conferences and in planning and evaluating the total… more
- CenterWell (Indianapolis, IN)
- …+ Monitor the following key functions: + Program evaluation + Risk Management + Utilization Review + Patient Care Evaluation + Policies and procedures + Human ... and keep records of criteria for admission to service, case assignments, and case management. + Represent...of home health services, and fourth largest pharmacy benefit manager , CenterWell is focused on whole-person health by addressing… more
- Elevance Health (Indianapolis, IN)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.… more
- Elevance Health (Indianapolis, IN)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients office visits with providers and external physicians.… more
- US Foods (Fishers, IN)
- …3rd Party Collection, Credit Hold, NSF activity, Policy exceptions, ACH utilization , and Cash Application metrics and statistics. + Establish and maintain ... benchmarking in support of the vision. Ability to create and sell a business case inclusive of budgeting, required resources, and ROI. **People Leadership - 30%** +… more