- Humana (Indianapolis, IN)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Prime Therapeutics (Indianapolis, IN)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions -RPH/PharmD required- REMOTE **Job Description ... and development of Medical Pharmacy program strategy as part of the Medical Pharmacy Specialty Clinical Solutions team. Responsible for managing current … more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Indianapolis, IN)
- … Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Indianapolis, IN)
- …opportunity for a Medical Director ( Medical Affairs). The Medical Affairs department provides clinical business support to the entire enterprise and ... Fortune 6 company, has an outstanding opportunity for a Medical Director - Medical Affairs....is a remote based from from home role. The Medical Affairs department provides clinical business support… more
- Humana (Indianapolis, IN)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Evolent Health (Indianapolis, IN)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of ... to make a difference in patients lives, in a non- clinical environment. You can enjoy better work- life balance...questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into… more
- CVS Health (Indianapolis, IN)
- …members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing and deploying our ... leader in serving dual eligible populations by utilizing best-in-class operating and clinical models in both our Dually Eligible Special Needs Plan (DSNP) and… more
- Kepro (Indianapolis, IN)
- … Director to join our growing team. Job Summary: The Part-Time Behavioral Health Medical Director shall provide the clinical and administrative medical ... leadership to the Behavioral Health physician reviewers. Moreover, the Medical Director will provide clinical ...in Utilization Management (UM) with knowledge of Medicaid and Medicare programs. + Prior Review experience or Quality Assurance… more
- Humana (Indianapolis, IN)
- …our caring community and help us put health first** The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex...and assisted by diverse resources, which may include national clinical guidelines, state policies, CMS policies and determinations, … more
- Humana (Indianapolis, IN)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...+ Excellent communication skills + 5 years of established clinical experience + Knowledge of the managed care industry… more
- Elara Caring (Indianapolis, IN)
- …this mission. This means you have countless ways to make a difference as Branch Director . Being a part of something this great starts by carrying out our mission ... pioneer in delivering unparalleled care, we need a Branch Director with commitment and compassion. Are you one of...+ Opportunities for advancement + Comprehensive insurance plans for medical , dental, and vision benefits + 401(K) with employer… more
- Evolent Health (Indianapolis, IN)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... rationale for standard and expedited appeals. + Utilizes medical / clinical review guidelines and parameters to assure...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- HealthEdge Software Inc (Indianapolis, IN)
- …to solve critical needs in healthcare. This individual will report to the Chief Medical Officer of Healthedge (HE) and ensure that our clinical suite of ... them: NCQA (National Committee for Quality Assurance), CMS (Centers for Medicare & Medicaid Services), URAC (Utilization Review Accreditation Commission) and other… more
- Elevance Health (Indianapolis, IN)
- ** Director I Compliance - Privacy** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of ... our Elevance Health PulsePoint locations. The ** Director I Compliance** is responsible for directing compliance/implementation of privacy initiatives. **How You Will… more
- Cardinal Health (Indianapolis, IN)
- …team is passionate about helping oncology practices navigate the future. The Director , Managed Care is responsible for strategy and management of managed care ... responsible to implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing… more
- Evolent Health (Indianapolis, IN)
- …management while working in conjunction with the Senior Medical Director . **Qualifications:** + MD/DO/MBBS + Current, unrestricted clinical license in ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- CenterWell (Avon, IN)
- …part of our caring community and help us put health first** The RN ** Clinical Manager** coordinates and oversees all direct care patient services provided by ... clinical personnel. Home Health and Oasis experience required +...final audits/billing are completed timely and in compliance with Medicare regulations. + Coordinates communication between team members/attending physicians/caregivers… more
- Prime Therapeutics (Indianapolis, IN)
- …of utilization management decisions. + On a requested basis, may function as Medical Director for select health plans or regions, assuming overall accountability ... as needed to discuss cases and problems. + Utilizes medical / clinical review guidelines and parameters to assure... Affairs. + Other duties as assigned. **Responsibilities** + Medicare Part D experience preferred. + Doctor of Medicine… more