• Utilization Management

    Humana (Indianapolis, IN)
    …help us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (11/13/24)
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  • Behavioral Health Medical Director

    Kepro (Indianapolis, IN)
    … Medical Director shall provide the clinical and administrative medical oversight for Behavioral Health Utilization Management reviews. The Medical ... the public sector. Acentra is looking for a Part-Time Behavioral Health Medical Director to join our...clinical specialty if MD or DO. + Experience in Utilization Management (UM) with knowledge of Medicaid… more
    Kepro (12/10/24)
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  • Utilization Management Registered…

    McLaren Health Care (Indianapolis, IN)
    We are looking for a Utilization Management RN to join us in leading our organization forward. McLaren Integrated HMO Group (MIG), a division of McLaren ... Inc. at https://www.mdwise.org/ **Position** **Summary:** This position is responsible for utilization management functions. This includes but is not limited… more
    McLaren Health Care (01/01/25)
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  • Behavioral Health Consultant- LCSW,…

    Community Health Network (Indianapolis, IN)
    …and facilitates trainings on specific bio-psychosocial approaches for the team. Assists with management of urgent behavioral health needs with medical ... Behavioral Health Consultant- LCSW, LMHC, or...required. - 2 + years of experience providing mental health treatment required. - Utilization of conventional… more
    Community Health Network (12/31/24)
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  • Care Manager Behavioral Health

    Highmark Health (Indianapolis, IN)
    …Time - Weekends Required.** This job implements the effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...years of post licensure experience in a combination of Behavioral Health Clinical, Case Management more
    Highmark Health (12/12/24)
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  • Behavioral Health Provider Quality…

    Elevance Health (Indianapolis, IN)
    **JR136085 Behavioral Health Provider Quality Manager** Responsible for leading Behavioral Health (BH) provider engagement, with a focus on leveraging ... quality outcomes. + Analyzes provider reports pertaining to cost, utilization , and outcomes, and presents the data to providers...applicable. **Minimum requirements:** + Requires MA/MS or above in Behavioral Health field and minimum of 10… more
    Elevance Health (12/06/24)
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  • Manager-Case Management

    Ascension Health (Indianapolis, IN)
    …to hire date or job transfer date. + Social Worker credentialed from the Indiana Behavioral Health and Human Services Licensing Board obtained prior to hire date ... areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and revise assignments daily to… more
    Ascension Health (11/19/24)
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  • Substance Use Disorder Therapist- Adult Inpatient…

    Community Health Network (Indianapolis, IN)
    …Use Disorder Therapist- Adult Inpatient Residential- Fairbanks- North Job Ref 2408056 Category Behavioral Health Job Family Behavioral Health Therapist ... - and we couldn't do it without you. **Make a Difference** The Behavioral Health Therapist Acute provides direct patient care through bio-psychosocial… more
    Community Health Network (12/05/24)
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  • Care Manager RN - Weekends (Remote)

    Highmark Health (Indianapolis, IN)
    …in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of health care services, ... utilization , identification of opportunities for referral to a Health Coach/case management , and identification and resolution...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (01/07/25)
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  • Oncology Medical Director- Commercial National…

    Elevance Health (Indianapolis, IN)
    …as related to oncology drivers. Responsible for the administration of physical and/or behavioral health medical services, to ensure the appropriate and most ... Director** will be supporting our clients in operations with utilization and case management reviews. In addition,...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (12/31/24)
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  • Senior Intake Coordinator

    Highmark Health (Indianapolis, IN)
    …:** **JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (11/09/24)
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  • Sexual Assault Prevention Response Victim Advocate…

    Army National Guard Units (Edinburgh, IN)
    …virtually, or in-person, with the victim's consent and preference. Develop detailed case management plans with short and long-term goals and objectives and engage in ... Requirements Conditions of Employment Qualifications Individual Occupational Requirement: Degree: behavioral or social science; or related disciplines appropriate to… more
    Army National Guard Units (12/31/24)
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  • Solution Director, SMI Total Cost of Care

    Elevance Health (Indianapolis, IN)
    …for over 150 years. With capabilities spanning pharmacy, behavioral health , complex care delivery, medical benefits management , payment integrity, palliative ... risk solution spans 100% of the total cost of care for our patients, integrating utilization management , care management , pharmacy management , and data… more
    Elevance Health (01/01/25)
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  • Associate Medical Director - Orthopedic Surgery

    Elevance Health (Indianapolis, IN)
    …A proud member of the Elevance Health family of companies, Carelon Behavioral Health , formerly Beacon Health Options, offers superior clinical mental ... preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For… more
    Elevance Health (12/17/24)
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  • Part-Time Weekend Medical Director (Remote)

    Highmark Health (Indianapolis, IN)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... (DO) **Substitutions** + None **Preferred** + Master's Degree in Business Administration/ Management or Public Health **EXPERIENCE** **Required** + 5 years… more
    Highmark Health (12/13/24)
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  • Clinical Transformation Consultant (Remote)

    Highmark Health (Indianapolis, IN)
    …, physician practice management or clinical operations, ancillary provider management or clinical operations, and/or health insurance) with significant ... knowledge of and experience with various care delivery models + Experience in health plan provider network performance management , care/case management ,… more
    Highmark Health (12/13/24)
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  • Chief Actuary - HMIG

    Highmark Health (Indianapolis, IN)
    …to deliver financial results to the Enterprise. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the… more
    Highmark Health (12/20/24)
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  • Senior Cloud Operations Engineer

    Highmark Health (Indianapolis, IN)
    …resource efficiency. + Proposes ideas, designs, and solutions to lead engineers and management to further cloud service utilization and optimization. + Develops ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...of action. + Level 3 Incident, problem and change management as it pertains to the responsibilities of the… more
    Highmark Health (10/25/24)
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  • Supervisor Intake Coordination - (Remote)

    Highmark Health (Indianapolis, IN)
    …contribute to highest levels of performance. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but limited to: involved in hiring and ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct, and control… more
    Highmark Health (01/02/25)
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  • Account Executive Enterprise Sales

    Highmark Health (Indianapolis, IN)
    …sales revenue and expanding market share through new client acquisition and relationship management . The ideal candidate will have a strong background in B2B sales, ... as: Financial Services, Utilities, Property and Casualty Insurance + CRM utilization **Preferred** + Transactional print and mail and digital delivery experience… more
    Highmark Health (12/27/24)
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