- 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. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Elevance Health (Indianapolis, IN)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Radiology Benefit Management /Utilization Review** ... radiology, cardiology and oncology. _ The **Clinical Operations Associate Medical Director ** is responsible for supporting the... Director ** is responsible for supporting the medical management staff ensuring timely and consistent… more
- Humana (Indianapolis, IN)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Indianapolis, IN)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Elevance Health (Indianapolis, IN)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- Centene Corporation (Indianapolis, IN)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Centene Corporation (Indianapolis, IN)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Elevance Health (Indianapolis, IN)
- …The ** Medical Director , Cardiology** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to ... **Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This...member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health,… more
- Evolent (Indianapolis, IN)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- CenterWell (Indianapolis, IN)
- …Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- Humana (Indianapolis, IN)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations.… more
- Humana (Indianapolis, IN)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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 … 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 ... **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 … more
- Humana (Indianapolis, IN)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- CVS Health (Indianapolis, IN)
- …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...be part of a centralized team that supports the Medical Management staff ensuring timely and consistent… 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 ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Merck (Indianapolis, IN)
- **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... claims about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
- Lilly (Indianapolis, IN)
- …to make life better for people around the world. **Purpose:** The Case Management Medical Review Scientist is responsible for conducting comprehensive medical ... position as necessary as defined in SOPs or as work evolves. A Case Management Medical Review Scientist is expected to meet the criteria as outlined in the… more
- Lilly (Indianapolis, IN)
- …clinical experience, the Cardiovascular/Cardiometabolic Business Unit - Global Medical Affairs Clinical Research Physician (CRP) Senior/Executive Director ... Responsibilities:** The primary responsibility of the Cardiometabolic Health Business Unit - Medical Affairs Senior/Executive Director is to provide expert … more
- Lilly (Indianapolis, IN)
- …states in other therapeutic indications as determined by Cardio-Renal and DOCTA management . The Executive Director will also supervise the implementation of ... to those who need them, improve the understanding and management of disease, and give back to our communities...leadership to a rapidly expanding cardio-renal portfolio. The Executive Director will report to the Senior Vice President of… more