- Lilly (Indianapolis, IN)
- …are determined to make life better for people around the world. **Purpose:** The Case Management Medical Review Scientist is responsible for conducting ... to the 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… 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 ... medical director supports product strategy/design through medical management that impact health care quality,... director is directly involved in Utilization Management and Case Management . +… more
- Humana (Indianapolis, IN)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health...in teams focusing on quality management , utilization management , case management , discharge planning… 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 ... caring community and help us put health first** The Medical Director relies on medical ...in teams focusing on quality management , utilization management , case management , discharge planning… 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)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... caring community and help us put health first** The Medical Director relies on medical ...in teams focusing on quality management , utilization management , case management , discharge planning… 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 ... caring community and help us put health first** The Medical Director actively uses their medical...in teams focusing on quality management , utilization management , case management , discharge planning… more
- 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. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Elevance Health (Indianapolis, IN)
- …The ** Medical Director , Cardiology** is responsible for supporting the medical management staff ensuring timely and consistent medical decisions to ... member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health,...attention, any case review decisions that require Medical Director review or policy interpretation. +… more
- Humana (Indianapolis, IN)
- …and experience with national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of requests received ... reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical … more
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