- Humana (Indianapolis, IN)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... requires a case by case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director will collaborate with clinicians and… more
- CVS Health (Indianapolis, IN)
- …And we do it all with heart, each and every day. **Position Summary** The Lead Director , Pharmacy Appeals will lead a team of 40+ colleagues in the ... internal business units to resolve issues quickly. The Lead Director , Pharmacy Appeals is also...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- CenterWell (Indianapolis, IN)
- **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 ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their… 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...overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy ), and reviews for… more
- Centene Corporation (Indianapolis, IN)
- …teams to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing ... + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the...complex cases and medical necessity appeals . + Participates in provider network development and new… more
- Centene Corporation (Indianapolis, IN)
- …teams to optimize outcomes. + Collaborates effectively with clinical teams, network providers, appeals team, medical and pharmacy consultants for reviewing ... perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the...complex cases and medical necessity appeals . + Participates in provider network development and new… more
- Humana (Indianapolis, IN)
- …and build collaborative care models in their practices + Coordinates with the Medical Director to integrate the administration and management of behavioral and ... in this role collaborates closely with Clinical Services and the Chief Medical Officer(CMO) to integrate the day-to-day administration and strategic management of… more
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