- CVS Health (Indianapolis, IN)
- …continuum of our members' health care and social determinant needs. The Duals Care Management (CM) Medical Director will participate in designing, developing ... and socioeconomic needs. * Partner closely with the Executive Director of Duals and other Duals Care Management...and quality objectives are met. * Consults with plan medical staff regarding adverse determinations, addresses issues related to… more
- Option Care Health (Indianapolis, IN)
- …presentations within Option Care and externally with customers (ex. medical director , head of case management , executive c-suite individuals). **Travel ... **Job Description Summary:** Under the direction of the Regional Sales Director , Health Systems Solutions (RSD, HSS), manages the development and execution… more
- Humana (Indianapolis, IN)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Indianapolis, IN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director actively uses their medical...in teams focusing on quality management , utilization management , case management , discharge planning… more
- Humana (Indianapolis, IN)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... in teams focusing on quality management , utilization management , case management , discharge planning...on size of region or line of business. The Medical Director conducts Utilization Management … more
- International Medical Group (Indianapolis, IN)
- …and/or high utilization of medical services and refer those identified for large case management . + Document information and status in case management ... when evaluating medical cases and confer with Medical Director when appropriate. + Communicate with...medical necessity as it relates to precertifications and case management . + Flexibility - must be… more
- Evolent Health (Indianapolis, IN)
- …training classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. ... 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… more
- Highmark Health (Indianapolis, IN)
- **Company :** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care ... delivery and complex case management for our community-based palliative care...leadership and guidance to the regional interdisciplinary team. The medical director collaborates clinically with the APP… more
- J&J Family of Companies (Indianapolis, IN)
- Director , Regulatory Medical Writing (1 of 4)...countries. Remote work options may be considered on a case -by- case basis and if approved by the company. ... - 2406211847W **Description** Johnson & Johnson is currently seeking a Director , Regulatory Medical Writing. The primary location for this position is the United… more
- Merck (Indianapolis, IN)
- …systems accounts + Serves as a resource for the HSO MAD Team Lead, HSO Executive Director Medical Affairs, and other members of Country Medical Affairs on ... **Job Description** **Health Systems Oncology Medical Affairs Director , US Medical...This role also serves as a resource for the Medical Affairs (MA) management team on strategic… more
- Humana (Indianapolis, IN)
- …5+ years of professional experience in Medicaid and/or Medicare managed care operations, case management , or health plan experience. + Active Registered Nurse ... community and help us put health first** The Associate Director , Care Management leads teams of nurses...pay and a comprehensive benefits package that includes 401k, Medical , Dental, Vision and a variety of supplemental insurances,… more
- Evolent Health (Indianapolis, IN)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Behavioral Health Field Medical Director will be a key member of the utilization management ... Opportunities:** Evolent Health is looking for a Behavioral Health Medical Director to be a member of...in risk management , claim adjudication, pharmacy utilization management , catastrophic case review, outreach programs, +… more
- National Youth Advocate Program (Indianapolis, IN)
- …clinical, medical and educational staff in identifying best case management practices while maintaining a collaborative multi-disciplinary environment; ... sponsors in local communities. NYAP works in collaboration with Federal agencies to provide case management services to arriving minors, so they can be reunified… 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...experience post-training providing clinical services + Experience in utilization management review and case management … more
- Merck (Indianapolis, IN)
- **Job Description** The Executive Director , Global Medical and Scientific Affairs (EDMA) GYN Malignancies is accountable for the development and execution of ... scientific & medical affairs Value and Implementation (V&I) plans for their...and Implementation (V&I) plan, in collaboration with the Executive Director of Scientific Affairs (EDSA), that guides TA scientific… more
- CVS Health (Indianapolis, IN)
- …**Position Summary** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Cardiology) that can be remote based, work from home. This ... can be remote based anywhere in the US. The Medical Director (Cardiology) will be a Subject...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- State of Indiana (Greenfield, IN)
- …Manage employee travel, time reporting and overtime to ensure maximum efficiency in case management and costs. + Establish and/or communicate and interpret ... Family Case Supervisor Date Posted: Sep 10, 2024 Requisition...well as provides training to new staff. + Identify management and organizational problems and provides training and development… more
- CVS Health (Indianapolis, IN)
- …preferably resides in North Carolina and have a NC License without encumbrances.** In the Medical Director role you will provide oversight for medical policy ... evaluation of clinical/ medical programs and expand Aetna's medical management programs to address member needs...In addition you will oversee utilization review/quality assurance, directing case management . In this role you'll provide… more
- CVS Health (Indianapolis, IN)
- …**This is a remote based (work at home) based anywhere in the US.** The Medical Director (Ortho/Total Joint) will be a Subject Matter Expert (SME) with a ... direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs...will lead all aspects of utilization review/quality assurance, directing case management . In this role you will… more
- Highmark Health (Indianapolis, IN)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more