• 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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  • 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 (10/18/25)
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  • RN Case Manager (Central Indiana)

    Elevance Health (Indianapolis, 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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  • 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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  • 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 (North…

    Elevance Health (Indianapolis, 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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  • 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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  • Summer 2026 Quality Analytics Undergraduate Intern

    Highmark Health (Indianapolis, IN)
    **Company :** Allegheny Health Network **Job Description :** Applicants must be authorized to work in the US independently. At this time, we do not offer visa ... of data, analyses, slides and preparation for CMS TEAMS and ED CT Utilization workgroups + Exposure to VBR work, including various programs, models, contracts, etc.… more
    Highmark Health (10/08/25)
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  • Pharmacy Benefit Consultant

    Highmark Health (Indianapolis, IN)
    …**Preferred** + 5 years of experience with communications + 3 years of experience in Utilization Review + 3 years of experience in Account Support + 1 year of ... + In-depth knowledge of the pharmacy industry, including benefit design, formulary management , and pharmacy best practices. + Proven ability to interpret and analyze… more
    Highmark Health (08/26/25)
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  • Psychologist Reviewer

    Centene Corporation (Indianapolis, IN)
    …are seeking a dedicated professional who is passionate about delivering high-quality, evidence-based behavioral health care. The ideal candidate will hold both a ... team environment** **Position Purpose:** Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical… more
    Centene Corporation (09/04/25)
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  • Highway Engineer

    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 ... and Highway Engineering, Technical Services, Environmental Services, Capital Program Management , Legal, Contract Administration, and Construction. The position will… more
    State of Indiana (10/17/25)
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  • Training and Staff Development Coordinator

    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 ... role provides day-to-day coordination and technical support for the Learning Management System (LMS), assists staff and leaders in navigating training resources,… more
    State of Indiana (10/17/25)
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