- Elevance Health (Indianapolis, IN)
- …Health office locations Work schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and ... of Elevance Health's family of brands, offering Medicaid and Medicare plans in several states. We also provide administrative...implementing clinical programs with specific medical condition focus for all lines of business enterprise… more
- CenterWell (Indianapolis, IN)
- …part of our caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic pharmacy leader responsible for developing, ... Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: +...(SME) and clinical liaison to the national clinical leadership (including Chief Medical Officer, Complex… more
- Prime Therapeutics (Indianapolis, IN)
- …our passion and drives every decision we make. **Job Posting Title** Director , Specialty Clinical Solutions- PharmD/RPH required- REMOTE **Job Description ... Medical Pharmacy clients and potential new clients. Required to serve as a Medical Pharmacy clinical resource throughout the organization and support all … 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)
- **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...reference materials, internal teaching conferences, and other reference sources. 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)
- …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 ... consumer experiences and a highly engaged team culture The Medical Director conducts clinical case... Medicare population and reports to the Lead Medical Director . Other duties: + Identify … more
- Humana (Indianapolis, IN)
- …our caring community and help us put health first** The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new ... and work is performed without direction. The Behavioral Health Medical Director actively uses their medical...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- Elevance Health (Indianapolis, IN)
- …May be responsible for an entire clinical program and/or independently performs clinical reviews. + The Medical Director typically has program management ... miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration...Director Associates. May be responsible for an entire clinical program. How you will make an impact: +… more
- CenterWell (Indianapolis, IN)
- …in Medicare /seniors * Demonstrated ability to work collaboratively with clinical and operational leaders across a complex health care organization. * Knowledge ... a part of our caring community and help us put health first** **National** ** Director of Transitional Care and High-Risk Patient Management** The Director of… more
- Cardinal Health (Indianapolis, IN)
- The Director , Channel Development Strategy- Diabetes for Cardinal Health's at-Home Solutions is responsible for providing enhanced relationship management for ... supply chains across public and private sectors, specifically including Medicare DMEPOS reimbursement landscape. + Comprehensive communication and negotiating skills… more
- CenterWell (Avon, IN)
- …a part of our caring community and help us put health first** The ** Clinical Manager** coordinates and oversees all direct care patient services provided by ... clinical personnel. + Develops, plans, implements, analyzes, and organizes clinical operations for a specific location managed. + Conducts/delegates the… 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
- State of Indiana (Indianapolis, IN)
- …* Review precertification requests for medical necessity, referring to the Medical Director those that require additional expertise. * Review clinical ... for ensuring the delivery of high quality, cost efficient medical outcomes for patients in need of inpatient and/or...Implementation of the attending physicians' decision of coverage/non-coverage of Medicare A. Reviews all Medicare A cases… more
- CenterWell (Indianapolis, IN)
- …participant and lead with the care team through daily huddles. * Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of ... coding specificity. * Follows policy and protocol defined by Clinical Leadership. * Meets with RMD about quality of...to write prescriptions under the authority of a collaborating physician/ medical director . + This role is considered… more
- The ALS Association (Indianapolis, IN)
- …nationwide network of chapters, coordinating multidisciplinary care through certified clinical care centers, and fostering government partnerships, The Association ... Manager is also responsible for facilitating education, information, benefits, and clinical resource navigation assistance to persons diagnosed with ALS and… more
- Highmark Health (Indianapolis, IN)
- …+ Manage individual projects for timely review with the Director , Clinical Pharmacy. + Participate in Medicare Stars performance measures to drive ... as an adjunct to health coaching. If acting in the capacity as a clinical pharmacist the incumbent may also review UM requests; provide consultation into the case… more
- Option Care Health (Indianapolis, IN)
- …and delivering presentations within Option Care and externally with customers (ex. medical director , head of case management, executive c-suite individuals). ... oncology, or transplant. + Basic understanding of billing and reimbursement procedures for hospital, medical offices, and Medicare (B/D + benefits) as well as … more