• Medical Director - Grievances

    Humana (Indianapolis, IN)
    Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse ... scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (09/17/24)
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  • Strategy Director

    Elevance Health (Indianapolis, IN)
    …will be considered.** **The Strategy Director ** supports Government Business Grievances & Appeals and Government Business Enrollment Billing. In this ... for this role. + Business knowledge in Government Health Benefits to include Grievances & Appeals and/or Enrollment Billing preferred. + Master's degree… more
    Elevance Health (09/11/24)
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  • Medical Director , Medicaid (Remote…

    Highmark Health (Indianapolis, IN)
    medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances , and other reviews as assigned. Compose clear ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
    Highmark Health (08/23/24)
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