- Evolent (Indianapolis, IN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Centene Corporation (Indianapolis, IN)
- …Performs other duties as assigned + Complies with all policies and standards We are seeking a Clinical Review Nurse - Concurrent Review to join our team! ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services...Compact State License + Post Acute Care Experience + Clinical Review Experience + Problem Solving Skills… more
- Fresenius Medical Center (Noblesville, IN)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Elevance Health (Indianapolis, IN)
- …states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse ** is responsible for review of the most complex or challenging ... ** Medical Management Nurse ** **Location: Virtual: This...management experience and requires a minimum of 2 years clinical , utilization review , or managed care experience;… more
- International Medical Group (Indianapolis, IN)
- …suggesting new ideas and seeking process improvements. + Judgment - use of good clinical judgment in resolving questions of medical necessity as it relates to ... As one of the world's top International Medical Insurance companies, IMG helps individuals and companies...of health care services, procedures, and facilities for utilization review and /or /evacuation/repatriation. Work as a liaison between… more
- Humana (Indianapolis, IN)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- CVS Health (Indianapolis, IN)
- …benefit overall claim management. + Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or other programs to ... in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993,… more
- Cardinal Health (Indianapolis, IN)
- …both scheduled outbound calls and inbound call queue. + Meets regularly with Clinical Supervisor and/or Senior Nurse , Individualized Care to discuss feedback ... who need them-faster.** **_What Individualized Care contributes to Cardinal Health_** Clinical Operations is responsible for providing clinical specialties… more
- BioLife Plasma Services (Indianapolis, IN)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. _BioLife ... results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works...Medical Support Specialist + Two years in a clinical or hospital setting **More about us:** At Takeda,… more
- State of Indiana (Indianapolis, IN)
- …service providers to facilitate the delivery of health and development services. + Review medical records and provides professional medical opinions and ... of where they live, learn, work, or play. Role Overview: The Chief Nurse Consultant serves as the Immunization Division's clinical subject matter expert… more