Top 293 Service transition manager Jobs in Indianapolis, In

DRG Clinical Validation Lead
Elevance Health —Indianapolis, IN
- $89,520 - $161,136 a year
- Full-time
- Nursing
- 7 years
- RN License
- Employee stock purchase plan
- Paid holidays
14d
Supervisory Contract Specialist (Branch Chief)
U.S. Customs and Border Protection —Indianapolis, IN
- $147,945 - $192,331 a year
- Online Application
- Remote
- Psychiatry
- Writing skills
- English
- Paid holidays
- Health insurance
14h
Learning Experience Designer
Salesforce —Indianapolis, IN
- $117,400 - $193,700 a year
- Full-time
- Continuous improvement
- Mentoring
- Organizational skills
- Paid parental leave
- Disability insurance
2d
Financial Program Specialist
U.S. Customs and Border Protection —Indianapolis, IN
- $75,374 - $97,991 a year
- Online Application
- Remote
- Psychiatry
- English
- Mid-level
- Paid holidays
- Health insurance
6d
Care Transition Liaison-Home Health
Optum —Indianapolis, IN
- $58,960 - $88,440 a year
- Full-time
- RN License
- Medical office experience
- Pass drug screening
Quick Apply
Change Manager
Renaissance Life & Health Insurance Co. —Indianapolis, IN
- $100,000 - $110,000 a year
- Full-time
- Remote
- 5 years
- Mid-level
- Bachelor's degree
- Opportunities for advancement
WMS Manager
Ulta Beauty, Inc. —Greenwood, IN
- $102,900 - $137,000 a year
- Full-time
- Microsoft Excel
- 3 years
- SQL
- Dental insurance
- Paid time off
Account Manager, Pharmacy Partnerships - Central & Southern IN
Optum —Indianapolis, IN
- $29 - $52 an hour
- Full-time
- Remote
- Pass drug screening
- Mid-level
- Business development
Field Manager
Lucas Oil Stadium —Indianapolis, IN
- Full-time
- Mentoring
- Senior level
- Outdoor work
- Free parking
- Health insurance
Deployment Manager
Baker Tilly Advisory Group, LP —Indianapolis, IN
- $84,000 - $135,000 a year
- Full-time
- Hybrid work
- Bachelor's degree
- Organizational skills
- Experience equivalent to degree accepted
Quick Apply
Social Worker
US Veterans Health Administration —Indianapolis, IN
- $62,297 - $97,991 a year
- Part-time
- Acute care
- Background check
- Master of Social Work
- Paid parental leave
- Paid holidays
8d
ReadUP Coordinator- Putnam County (Contractor)
United Way of Central Indiana —Indianapolis, IN
- $35 - $70 an hour
- Contract
- Hybrid work
- School experience
- Computer literacy
- Writing skills
Quick Apply
5d
Business Operations Manager
Birge & Held Group LLC —Indianapolis, IN
- $75,000 - $90,000 a year
- 8 hour shift
- Hybrid work
- Mid-level
- Office
- 3 years
- Wellness program
- Paid parental leave
Quick Apply
Executive Liaison
Indiana University —Indianapolis, IN
- Full-time
- Office
- University
- Bachelor's degree
- Paid parental leave
- Health savings account
Senior Community Manager
Edward Rose & Sons —Carmel, IN
- Clean driving record
- Driver's License
- Apartments
- Paid time off
- On-the-job training
Quick Apply
Human Resources Specialist (Information Systems)
U.S. Customs and Border Protection —Indianapolis, IN
- $125,776 - $163,514 a year
- Online Application
- Remote
- Psychiatry
- English
- Office
- Paid holidays
- Health insurance
5d
Director, Facilities & Maintenance
Ivy Hospitality - Corporate Office —Indianapolis, IN
- $110,000 - $130,000 a year
- Full-time
- 18 years or older
- 7 years
- Construction site
- Health savings account
- AD&D insurance
Quick Apply
LPN - Advanced Care Planning Specialist, Remote
Aledade PBC —Indianapolis, IN
- $28.85 an hour
- 8 hour shift
- Remote
- Spanish
- Nursing
- Mid-level
- Paid parental leave
- Paid holidays
Quick Apply
Case Management Extender- North
Community Health Network —Indianapolis, IN
- Part-time
- Hospital
- Customer service
- Writing skills
- Tuition reimbursement
Classroom Program Manager
Damar Services, Inc. —Indianapolis, IN
- Full-time
- Background check
- Classroom
- 18 years or older
- Paid holidays
- Disability insurance

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DRG Clinical Validation Lead

Elevance Health -
Indianapolis, IN

Apply Now

Job Details

Full-time
$89,520 - $161,136 a year
14 days ago

Benefits

Employee stock purchase plan
Paid holidays
Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Nursing
RN License
Managed care organization experience
Acute care experience
Nursing

Full Job Description

DRG Clinical Validation Lead

Anticipated End Date: 8/28/2026

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

The DRG Clinical Validation Lead ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs or community resources. Works with medical directors in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied.

How you will make an impact:

Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Ensures member access to medical necessary, quality healthcare in a cost effective setting according to contract.
Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process.
Collaborates with providers to assess member's needs for early identification of and proactive planning for discharge planning.
Facilitates member care transition through the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications.
Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
Serves as the team lead and responds to the most complex medical issues.
Ensures consistency in benefit application. May lead cross-functional teams, projects, initiatives, process improvement activities, and requires previous managed care experience.
May serve as departmental liaison to other areas of the business unit or as representative on enterprise initiatives..

Minimum Requirements:

Requires AS in nursing and minimum of 7 years of acute care clinical experience; or any combination of education and experience, which would provide an equivalent background. Prior managed care experience required. Current unrestricted RN license in applicable state(s) required.

Preferred Skills, Capabilities and Experiences:

One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC.
Experience with third party DRG Coding and/or Clinical Validation Audits or hospital clinical documentation improvement experience preferred.
Broad knowledge of clinical documentation improvement guidelines, medical claims billing and payment systems, provider billing guidelines, payer reimbursement policies, and coding terminology preferred.
Lead experience preferred.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $89,520 to $161,136

Locations: California; Colorado, Illinois, Maryland, Minnesota, Nevada; New York; Washington State

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act

Apply Now

Refine Your Search

service transition manager jobs in indianapolis, in

DRG Clinical Validation Lead

Supervisory Contract Specialist (Branch Chief)

Learning Experience Designer

Financial Program Specialist

Care Transition Liaison-Home Health

Change Manager

WMS Manager

Account Manager, Pharmacy Partnerships - Central & Southern IN

Field Manager

Deployment Manager

Social Worker

ReadUP Coordinator- Putnam County (Contractor)

Business Operations Manager

Executive Liaison

Senior Community Manager

Human Resources Specialist (Information Systems)

Director, Facilities & Maintenance

LPN - Advanced Care Planning Specialist, Remote

Case Management Extender- North

Classroom Program Manager

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