• Utilization Management

    Humana (Indianapolis, IN)
    …us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
    Humana (10/17/25)
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  • Behavioral Health Clinical Quality…

    Elevance Health (Indianapolis, IN)
    …and a minimum of 3 years experience in quality improvement and/or behavioral health , risk management and/or utilization review in a managed care setting ... **JR167284 Behavioral Health Clinical Quality Audit Analyst, Sr** Responsible for maintaining crisis accreditation and developing, delivering and evaluating… more
    Elevance Health (10/13/25)
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  • Medical Director, Medical Management

    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 (10/15/25)
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  • National Accounts Medical Director

    Elevance Health (Indianapolis, IN)
    …to day clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... medical director provides clinical expertise in all aspects of utilization review and case management . Provides input...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
    Elevance Health (09/23/25)
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  • Transplant Care Nurse - Remote

    Highmark Health (Indianapolis, IN)
    …of clinical, case/ utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... health status/severity and clinical needs; and assesses health management needs of the assigned member...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
    Highmark Health (10/10/25)
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  • Care Management Coordinator

    Highmark Health (Indianapolis, IN)
    …timeframes and notification requirements are met. + Communicate effectively with Utilization Management Staff, providers, other internal and external customers ... processing of pre-certification requests for authorization of medically necessary health care services, at the appropriate level of care,...and management . + Route Cases Based on Established Guidelines. +… more
    Highmark Health (10/16/25)
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  • CFSP Managed Care Coordinator- Region 7

    Elevance Health (Wilkinson, IN)
    … under the CFSP Care Management model, including coordination across physical health , behavioral health , I/DD, LTSS, pharmacy, and unmet health ... access to the same basic benefits and services, including Physical health , Behavioral health , Pharmacy,_ _Intellectual/Developmental_ _Disabilities (I/DD)… more
    Elevance Health (10/07/25)
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  • LTSS Service Coordinator (Case Manager)

    Elevance Health (Greenwood, IN)
    …member's circle of support and overall management of the individuals physical health (PH)/ behavioral health (BH)/LTSS needs, as required by applicable ... associates, and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation… more
    Elevance Health (10/16/25)
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  • Case Manager, Registered Nurse - Fully Remote

    CVS Health (Indianapolis, IN)
    …. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health /Substance Abuse or Maternity/ Obstetrics experience.… more
    CVS Health (10/15/25)
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  • Chief Medical Officer (CMO)

    Community Health Systems (Fort Wayne, IN)
    …and agenda for improvement in clinical outcomes, as well as resource utilization , patient-centered care coordination, and patient experience so as to optimize the ... and northwestern Ohio. Accredited by The Joint Commission and part of Lutheran Health Network, we are dedicated to providing compassionate, quality care with the… more
    Community Health Systems (10/07/25)
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  • RN Case Manager (Northeast Indiana)

    Elevance Health (Fort Wayne, IN)
    …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... engagement. The **RN Case Manager** is responsible for overall management of member's case within the scope of licensure;...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a… more
    Elevance Health (08/30/25)
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  • Disease Management Nurse - Remote

    Sharecare (Indianapolis, IN)
    …members to become empowered and active participants in their own healthcare management for their chronic condition. By providing health education and ... **Job Description:** Sharecare is the leading digital health company that helps people - no matter...nurse helps to drive cost effective and appropriate resource utilization and desired clinical outcomes. The Disease Management more
    Sharecare (09/13/25)
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  • 001bd1 - BDS Case Management Liaison

    State of Indiana (Indianapolis, IN)
    …+ Referral Bonus program + Employee assistance program that allows for covered behavioral health visits + Qualified employer for the Public Service Loan ... 001BD1 - BDS Case Management Liaison Date Posted: Oct 10, 2025 Requisition...of this role are as follows: + Promotes the utilization of technical services to resolve business issues within… more
    State of Indiana (10/10/25)
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  • IN Care Manager, Suicide Prevention Program

    Mindoula Health (IN)
    …you successful: + Bachelors degree in psychology, social work, or another applicable behavioral health discipline from an accredited college or university is ... basis + Develop and coordinate community resources with emphasis on medical, behavioral , violence prevention, and social services. + Assess members for risk, make… more
    Mindoula Health (10/17/25)
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  • Change Execution Consultant

    Highmark Health (Indianapolis, IN)
    **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job plays a key role in ensuring projects (ie change initiatives) meet objectives on time ... and minimize risk to implementation. Works to drive faster adoption, higher ultimate utilization and greater proficiency of the changes that impact employees in the… more
    Highmark Health (09/19/25)
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  • Case Manager -LCSW/LSW/LMSW/LMHC/LMFT (East…

    Elevance Health (IN)
    …identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... care team, to ensure cost effective and efficient utilization of health benefits. + Decision making...Experiences:** + Experience working with older adults in care management , provider or other capacity, highly preferred. + Experience… more
    Elevance Health (08/30/25)
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  • Physician - Psychiatrist

    Veterans Affairs, Veterans Health Administration (IN)
    … disorders. Provides various treatment therapeutics including medication management , individual, marital and group psychotherapies as indicated. Provides ... the VISN 10 Clinical Resource Hub (CRH) under the guidance of Veteran Health Administration (VHA), which provides health care services to Veteran patients… more
    Veterans Affairs, Veterans Health Administration (10/11/25)
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  • Senior Architect - Cloud

    Highmark Health (Indianapolis, IN)
    **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This role is responsible for designing, developing, implementing, supporting, and optimizing ... solutions, networks, and infrastructure. Ensure optimal technology selection, resource utilization , and seamless integration. + Utilize modeling tools to develop… more
    Highmark Health (07/22/25)
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  • Manager IT Dental Solutions

    Highmark Health (Indianapolis, IN)
    …within the Scrum Master and PO CoE teams through coaching, performance management , and fostering collaboration. The manager provides **oversight for Scrum Masters** ... **leading the Agile Transformation** , including strategic planning, change management , stakeholder engagement, tracking transformation metrics, and fostering continuous… more
    Highmark Health (10/17/25)
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  • Quality Assurance Coordinator

    BrightSpring Health Services (Indianapolis, IN)
    …community living, adult host homes for adults regardless of disability, behavioral /mental health support, in-home pharmacy solutions, telecare and remote ... is focused on maintaining local compliance with State, Federal and BrightSpring Health requirements. The QAC provides leadership oversight to operations in meeting… more
    BrightSpring Health Services (10/16/25)
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