133 Healthcare jobs in Brownsburg

Willow Springs Healthcare Center is hiring! Willow Springs is under new management and ready to continue and build a culture that puts our patients and staff first! If you are an enthusiastic nurse who wants to make a difference in the lives of others, look no further than Willow Springs! Located in the beautiful Palm Desert area, Willow Springs serves short- and long-term patients. Meet with us today!

Pay: From $52.00 per hour and up (Let's talk! We value our nurses!)

PER DIEM opportunity

Qualifications:

• Valid CA RN License

• Assess, diagnose, and manage chronic and acute conditions.
• Provide health education.
• Develop treatment plans and effectively verbalize those to residents and other appropriate providers, caregivers, etc.
• Order and interpret appropriate lab and diagnostic testing and adjust treatment plans accordingly.
• Maintain appropriate and compliant documentation within our EMR (electronic medical record) software.
• Collaborate with local and regional operations and clinical leadership to achieve goals.
• Support strategic initiatives regarding value-based care.
• Provide an excellent customer experience to foster high customer satisfaction/retention.
• Practice ethically and in accordance with the Scope and Standards of Practice of their profession and Board Certification.
• Follow all state and federal regulations, guidelines, and laws.
• Collaborate with PCP and interdisciplinary care team at facility.
• Coordinate care with other providers and specialists including telemedicine providers.
• Complete all regulatory required monthly, quarterly, and/or annual visits and acute visits as needed.
• Participate in family conferences and provide advanced care planning and education when needed.
• Address any pharmacy recommendations or pharmacist communications regarding residents.
  Providers are expected to be present in assigned facilities during work hours to ensure that facilities have adequate face-to-face coverage to meet resident care and facility needs.

• Master of Science in Nursing, Doctor of Nursing Practice, or NP Certificate Program graduate
• National certification of AANP or ANCC
• Active, unrestricted state license
• Active DEA license
• US work authorization
• 2+ years clinical experience as a Nurse or Nurse Practitioner in geriatric, adult or family practice setting
• Ability to work in a flexible environment and schedule
• Passionate about providing healthcare to the senior and low-income populations

• Training or clinical experience in geriatrics
• 2+ years clinical experience as a Nurse Practitioner
• Experience with coding, ICD-10 and HCC (Hierarchical Condition Categories)
• Experience or training working in a metrics, results driven healthcare model
• Be open to professional development through training, obtaining certifications if necessary, and attending team meetings
• Experience working in value-based care models
• Training or experience in geriatric, assisted living, and/or skilled nursing setting
• Experience working in a collaborative healthcare setting to drive positive outcomes and achieve goals
• Training or experience in outpatient primary care setting

• Must have strong oral and written communication skills
• Must be detail oriented with an ability to work well both independently and in a team setting
• Exhibit a customer service approach with teams and residents
• Strong time management skills required. Must be able to prioritize and adhere to competing deadlines while achieving goals

• Assess, diagnose, and manage chronic and acute conditions.
• Provide health education.
• Develop treatment plans and effectively verbalize those to residents and other appropriate providers, caregivers, etc.
• Order and interpret appropriate lab and diagnostic testing and adjust treatment plans accordingly.
• Maintain appropriate and compliant documentation within our EMR (electronic medical record) software.
• Collaborate with local and regional operations and clinical leadership to achieve goals.
• Support strategic initiatives regarding value-based care.
• Provide an excellent customer experience to foster high customer satisfaction/retention.
• Practice ethically and in accordance with the Scope and Standards of Practice of their profession and Board Certification.
• Follow all state and federal regulations, guidelines, and laws.
• Collaborate with PCP and interdisciplinary care team at facility.
• Coordinate care with other providers and specialists including telemedicine providers.
• Complete all regulatory required monthly, quarterly, and/or annual visits and acute visits as needed.
• Participate in family conferences and provide advanced care planning and education when needed.
• Address any pharmacy recommendations or pharmacist communications regarding residents.
  Providers are expected to be present in assigned facilities during work hours to ensure that facilities have adequate face-to-face coverage to meet resident care and facility needs.

• Master of Science in Nursing, Doctor of Nursing Practice, or NP Certificate Program graduate
• National certification of AANP or ANCC
• Active, unrestricted state license
• Active DEA license
• US work authorization
• 2+ years clinical experience as a Nurse or Nurse Practitioner in geriatric, adult or family practice setting
• Ability to work in a flexible environment and schedule
• Passionate about providing healthcare to the senior and low-income populations

• Training or clinical experience in geriatrics
• 2+ years clinical experience as a Nurse Practitioner
• Experience with coding, ICD-10 and HCC (Hierarchical Condition Categories)
• Experience or training working in a metrics, results driven healthcare model
• Be open to professional development through training, obtaining certifications if necessary, and attending team meetings
• Experience working in value-based care models
• Training or experience in geriatric, assisted living, and/or skilled nursing setting
• Experience working in a collaborative healthcare setting to drive positive outcomes and achieve goals
• Training or experience in outpatient primary care setting

• Must have strong oral and written communication skills
• Must be detail oriented with an ability to work well both independently and in a team setting
• Exhibit a customer service approach with teams and residents
• Strong time management skills required. Must be able to prioritize and adhere to competing deadlines while achieving goals

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary/Mission

The role of Medical Director - Clinical Support is an exciting opportunity for a physician to use their clinical background, skills, and experience to help improve the health and well-being of our members at the individual and population health levels. The Medical Director provides clinical leadership and support to our portfolio of clinical products and programs as well as sales and account management. Duties include support for - case management, clinical content research & development, chronic condition management, lifestyle and well-being programs, clinical support of prospects and existing clients, educational support to clinical staff, account & sales teams, and other clinically-related services as assigned.

Fundamental Components & Physical Requirements

• Collaborate with internal and external stakeholders to optimize member care and outcomes.

• Support clinical operations' delivery of population health interventions - including and not limited to reviewing care plans, conducting case reviews, providing clinical guidance.

• Identify areas for improvement and support initiatives to address gaps and optimize processes.

• Communicate effectively presenting clinical insights, strategies, and performance reports.

• Support research initiatives aimed at evaluating solution outcomes.

• Collaborate with the sales and business development teams to support client acquisition and retention efforts.

• Ensure provision of clinical expertise and insights during client meetings, presentations, and negotiations.

• Develop clinical content for sales collateral, proposals, and client communications to showcase the value of our population health solutions.

• Participate in client onboarding processes, ensuring smooth transitions and alignment of clinical services with client needs and goals.

• Act as a medical advisor and liaison for key client accounts, addressing clinical inquiries, concerns, and escalations.

• Represent the company in medical conferences, seminars, and industry events.

• Stay updated with the latest clinical research, trends, and technologies relevant to population health management.

• Support innovation by identifying opportunities for new programs, services, or partnerships that enhance member care and outcomes.

Required Qualifications

Minimum of 3 years of clinical experience in health care delivery (clinical practice)

Experience in managed care, care management, utilization management, quality management, or population health

MD or DO degree, Board Certification in a ABMS or AOA recognized specialty including post-graduate patient care training

Preferred Qualifications

Comprehensive knowledge of Microsoft Office Suite

Electronic Medical System experience (Epic will be most useful)

Strong organizational skills

Ability to set and achieve goals

Ability to multi-task effectively and efficiently

Strong oral, presentation, and written skills

Strong interpersonal skills

Ability to work independently and adapt to team approach as necessary

Strong ability to work in and affect change in a highly matrixed environment

Additional training or experience in Health IT and analytics

Education

MD or DO degree, Board Certification in a ABMS or AOA recognized specialty including post-graduate patient care training

Active and current state medical license (any state)

Ability to get additional state medical licenses as required for the business

Clinical Licensure Required

Current, unrestricted U.S. medical license

Board Certified MD

May be required to get additional state licenses

Location

• Work From Home - Mid-Atlantic or Southeast preferred (will consider any state) Work from Home - Ability to work East Coast hours.

• Travel: 20 %

Pay Range

The typical pay range for this role is:

$174,070.00 - $374,920.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan .

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit

We anticipate the application window for this opening will close on: 10/01/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.

The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.

The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits for all lines of business. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations

• Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements

• Engage with requesting providers as needed in peer-to-peer discussions

• Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews

• Participate in daily clinical rounds as requested

• Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy

• Communicate and collaborate with other internal partners

• Call coverage rotation

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• M.D or D.O.

• Active unrestricted license to practice medicine

• Board certification in an ABMS specialty

• 5+ years of clinical practice experience after completing residency training

• Sound understanding of Evidence Based Medicine (EBM)

• Proven solid PC skills, specifically using MS Word, Outlook, and Excel

• Ability to participate in call coverage rotation

Preferred Qualifications:

• Licensed in AZ, CA, MA, MN or TX

• Board certified in family medicine or internal medicine

• Experience in utilization and clinical coverage review

• Proven excellent oral, written, and interpersonal communication skills, facilitation skills

• Proven data analysis and interpretation aptitude

• Proven innovative problem-solving skills

• Proven excellent presentation skills for both clinical and non-clinical audiences

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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 where the analysis of situations or data requires an in-depth evaluation of variable factors.

The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to operationalize this knowledge in their daily work.

The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records, prioritization of daily work, communication of decisions to internal associates, and possible participation in care management. The clinical scenarios predominantly arise from inpatient or post-acute care environments. Has discussions with external physicians by phone to gather additional clinical information or discuss determinations regularly, and in some instances these may require conflict resolution skills. Some roles include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope.

The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical Directors support Humana values, and Humana's Bold Goal mission, throughout all activites.

Use your skills to make an impact

Responsibilities

The Medical Director provides medical interpretation and determinations whether services provided by other healthcare professionals are in agreement with national guidelines, CMS requirements, Humana policies, clinical standards, and (in some cases) contracts. The ideal candidate supports and collaborates with other team members, other departments, Humana colleagues and the Regional VP Health Services. After completion of mentored training, daily work is performed with minimal direction. Enjoys working in a structured environment with expectations for consistency in thinking and authorship. Exercises independence in meeting departmental expectations, and meets compliance timelines. Supports the assigned work with respect to market-wide objectives (e.g. Bold Goal) and community relations as directed.

Required Qualifications

• MD or DO degree

• 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare type population (disabled or >65 years of age).

• Current and ongoing Board Certification an approved ABMS Medical Specialty

• A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required.

• No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements.

• Excellent verbal and written communication skills.

• Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation.

Preferred Qualifications

• Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management.

• Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance.

• Experience with national guidelines such as MCG® or InterQual

• Internal Medicine, Family Practice, Geriatrics, Hospitalist, Emergency Medicine clinical specialists

• Advanced degree such as an MBA, MHA, MPH

• Exposure to Public Health, Population Health, analytics, and use of business metrics.

• Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.

• The curiosity to learn, the flexibility to adapt and the courage to innovate

Additional Information

Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned market, member population, or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational committees.

#physiciancareers

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$223,800 - $313,100 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 08-10-2025

About us

Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our