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Remote Hca Utilization Review Jobs in Indiana (NOW HIRING)

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · On-site +1

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database users' needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database users' needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database users' needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · On-site +1

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database user needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database user needs to estimate time and cost required to ...

A.C. Coy

Cobol/IDMS Developer (Remote)

Indianapolis, IN · Remote

$48 - $65/hr

... and utilization of electronic data processing systems for product and commercial software ... Review project requests describing database user needs to estimate time and cost required to ...

Harris

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Harris

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

Cayenta

... reviews and documentation, and requirements elicitation, allowing the project team to gain a ... utilization of assigned resources. * Be a leader in providing subject matter expertise to R&D and ...

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Remote Hca Utilization Review information

What is the difference between Remote Hca Utilization Review vs Remote Hca Case Manager?

AspectRemote Hca Utilization ReviewRemote Hca Case Manager
CredentialsTypically requires healthcare-related certifications, such as RN or licensed healthcare professionalOften requires RN, social work, or case management certifications
Work EnvironmentPrimarily reviewing medical necessity and insurance coverage remotelyManaging patient cases, coordinating care, and discharge planning remotely
Employer & Industry UsageUsed by health insurance companies, healthcare providers, and utilization review organizationsEmployed by hospitals, insurance companies, and healthcare organizations

Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.

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What job categories do people searching Remote Hca Utilization Review jobs in Indiana look for? The top searched job categories for Remote Hca Utilization Review jobs in Indiana are:
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Remote Hca Utilization Review jobs near you
Physician / Cardiology / Indiana / Permanent / Associate Medical Director - Cardiology - 100% Remote

Physician / Cardiology / Indiana / Permanent / Associate Medical Director - Cardiology - 100% Remote

eviCore healthcare

Indianapolis, IN • Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Job description

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.
Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Maintains necessary credentials and immediately informs eviCore of any adverse actions relating to medical licenses and/or board certifications.
Participates in strategic planning for and evaluation of the Care Management
The successful candidate will be an M.D. or D.O. with a current, active, U.S. state medical license and board certified in Cardiology, recognized by the American Board of Medical Specialties (ABMS), with recent practice experience in direct patient care (within the past 18 months).
Must have a minimum of 5 years clinical experience, beyond residency/fellowship
Knowledge of applicable state and federal laws, URAC and NCQA standards a plus, and familiarity with automated processes and computer applications and systems is required
No nights, no weekends, not call.
Predictable work schedule
Full and part time opportunities
Salaried position with benefits
Supportive organization with collaborative culture
eviCore healthcare is committed to making a positive impact on healthcare, and also making a positive impact on our employees. eviCore offers a variety of perks and benefits including, but not limited to:
Flexible scheduling and work/life balance with remote and work from home opportunities
4 weeks of PTO(starting) per year plus paid holidays
One week of CME
Education assistance, tuition reimbursement and professional certifications
Health, dental, vision, and life benefits with employer funded HSA
Paid Volunteer Community Service Days
Ample opportunities for growth, advancement, and promotion
401k retirement plan with company match of 50% employee contributions up to 6%
eviCore is committed to hiring and retaining a diverse workforce. We are an Equal Opportunity Employer, making decisions without regard to race, color, religion, sex, national origin, age, veteran status, disability, or any other protected class. Applicants must be able to pass a drug test and background investigation

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