- 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 North Job...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
- Elevance Health (Indianapolis, IN)
- …is licensed staff supervision. **Preferred Qualifications** + Previous experience in case management/ utilization management with a broad range of experience ... **Behavioral Health Care Manager I Overnight and Weekend Team** **Location:** Remote/work...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses… more
- Elevance Health (Indianapolis, IN)
- …+ Licensure is a requirement for this position. + Previous experience in case management/ utilization management with a broad range of experience with complex ... may be asked to work in office as needed.** The **Behavioral Health Care Manager I** - **Indiana** is responsible for managing psychiatric and substance abuse or… more
- Elevance Health (Indianapolis, IN)
- …must be located in a state or territory of the United States when conducting a 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 patient's office visits with providers and external physicians.… 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
- 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
- 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