- Waterford Crossing (Goshen, IN)
- …Licensed Practical Nurse (LPN) is primarily responsible for providing direct, quality clinical care and the supervision of nursing assistants working with residents ... and notify the charge nurse, the physician, and/or the Director of Nursing when there is a change in...your LPN license.Assist in monitoring the inventory of medications, medical supplies and equipment to ensure that an adequate… more
- Highmark Health (Indianapolis, IN)
- …responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using ... Medical Policy criteria sets to evaluate the ... necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic… more
- Elevance Health (Indianapolis, IN)
- …our care management models for our National Account clients. The medical director will be responsible for supporting the clinical vision and implementation ... the health improvement tools offered to clients/ members. The medical director provides clinical expertise...clinical relevance to account reporting regarding use of medical services by members. Involved in identifying… more
- Humana (Indianapolis, IN)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the… more
- Humana (Indianapolis, IN)
- …team and fulfill day-to-day leadership responsibilities . Engage the Medical Director whenever additional leadership or clinical support is needed **Use your ... the Healthcare Quality Reporting and Improvement organization. They report to the National Medical Director and lead a diverse team driving education strategy… more
- Elevance Health (Indianapolis, IN)
- ** Clinical Operations Medical Director ** **Carelon MBM** **Virtual:** This role enables associates to work virtually full-time, with the exception of ... medical appropriate information in order to make medical necessity determinations for services requested. +... Director review or policy interpretation. + Determine medical necessity of requests using applicable clinical … more
- Elevance Health (Indianapolis, IN)
- ** Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Radiology Benefit Management/Utilization Review** _A proud ... an accommodation is granted as required by law._ The ** Clinical Operations Associate Medical Director **... medical appropriate information in order to make medical necessity determinations for services requested. +… more
- State of Indiana (Richmond, IN)
- …+ Serve as a primary clinical leader to assist the Superintendent and Medical Director in ensuring exceptional patient care. + Manage, oversee, and maintain ... Clinical Director Date Posted: Sep 21,...supervision to Clinical Department Heads, staff providing clinical services , and other subordinates as assigned.… more
- Prime Therapeutics (Indianapolis, IN)
- …our passion and drives every decision we make. **Job Posting Title** Sr Director Clinical Strategy and Oncology Specialty Solutions/PharmD required- REMOTE **Job ... Description** The Senior Director Clinical Strategy and Oncology Specialty Solutions...the development of strategic business roadmaps that integrate both medical and pharmacy solutions. This position will provide leadership… more
- Cognizant (Indianapolis, IN)
- …submit the medical necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with ... denials including but not limited to referral, preauthorization, medical necessity, non-covered services , investigational/experimental and billing resulting… more
- Highmark Health (Indianapolis, IN)
- …anchor, including MAQCs and pharmacists, in collaboration with the partnership director who manages non- clinical workforce activity. + **Relationship Management ... :** **JOB SUMMARY** This role will support the leadership team for Clinical Transformation and executive physicians in leading the day-to-day operational model of… more
- Grifols Shared Services North America, Inc (Terre Haute, IN)
- …(MSL primary call points include Immunology, Neurology, Hematology/Oncology). The Field Director ensures compliant execution of field medical plans, strategy, ... and develop, produce and market innovative medicines, solutions and services in more than 110 countries and regions. The...solutions for the therapeutic area(s). + Partners with the Medical Directors, National MSL Sr Director , and… more
- Humana (Indianapolis, IN)
- …processes, and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, ... , requested level of care, and/or requested site of service should be authorized. All work occurs with a...**Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided… more
- Humana (Indianapolis, IN)
- …an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... clinical documentation, dispute/grievance and appeals processes, and outpatient services and equipment, within their scope. Medical ...a Lead Medical Director . The Medical Director conducts post- service , inpatient… more
- Humana (Indianapolis, IN)
- …all activities. **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other ... Medical Director 's work includes reviewing of all submitted medical records, synthesizing complex hospital-based clinical scenarios, and providing expert… more
- Ascension Health (Indianapolis, IN)
- …**Responsibilities:** + Organize operations to provide high quality, cost effective services . Model leadership and teaming excellence by providing appropriate advice ... + Develop and implement policies and procedures that support the delivery of services to meet allproductivity plans. + Coordinate and integrate services to… more
- CenterWell (Indianapolis, IN)
- … Medical Director for Home-Based Care Programs is a key clinical leadership position responsible for the medical direction, clinical oversight, ... polychronic, and high-risk Medicare patients within a full-risk, value-based framework. The Medical Director collaborates in a dyad partnership with the Strategy… more
- Humana (Indianapolis, IN)
- …an impact** **Responsibilities** The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... caring community and help us put health first** The Medical Director relies on medical ...medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with… more
- Evolent (Indianapolis, IN)
- …non- clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...Inspector General of the Department of Health and Human Services or the General Service Administration (GSA),… more
- Elevance Health (Indianapolis, IN)
- ** Medical Director -Dermatology Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... an accommodation is granted as required by law. The ** Medical Director -Dermatology Appeals** is responsible for the...responsible for the review of appeals for physical health medical services , to ensure the appropriate and… more
