• Medical Director - (Pain Management SME)

    CVS Health (Austin, TX)
    …Summary** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Pain Management) that can be remote based, work from home. This role can ... be remote based anywhere in the US. The Medical Director (Pain Management) will be a Subject Matter Expert (SME) with a background in Pain Management specialty,… more
    CVS Health (09/06/25)
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  • Corporate Medical Director - Medicare…

    Humana (Austin, TX)
    …Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate Medical Director works on problems ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the appropriateness...MD or DO degree + A current and unrestricted license in at least one state and willing to… more
    Humana (09/05/25)
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  • Medical Director - Medicare Grievances…

    Humana (Austin, TX)
    …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
    Humana (09/06/25)
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  • Remote Medical Director - Texas

    Centene Corporation (Austin, TX)
    …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
    Centene Corporation (08/16/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Austin, TX)
    …IL, OH, ID, SC, UT, WI, MA, NV, IA, GA + Active AZ MD license **Job Duties** + Provides medical oversight and expertise in appropriateness and medical necessity of ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
    Molina Healthcare (08/28/25)
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  • Regional CM/CEI Practice Director

    Johnson, Mirmiran, and Thompson Inc. (Houston, TX)
    …News-Record's list of the Top 500 Design Firms. JMT is seeking Regional CM/CEI Practice Director for any of our Texas locations. The successful leader will be r esp ... CM services include c onstruction and p rogram management, construction inspection, claims s upport, scheduling and cost estimating, project controls and other… more
    Johnson, Mirmiran, and Thompson Inc. (07/12/25)
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  • Director , Applications (AI/Azure…

    Molina Healthcare (Fort Worth, TX)
    …with AI Data Integration._** + **_Experience with Member, Enrollment, and Claims applications -_** **which underpin essential business functions such as HEDIS ... **_Azure Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License , Certification, Association** Microsoft Technology, Mobility, ITIL To all… more
    Molina Healthcare (06/29/25)
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  • Senior Staff Analyst - Risk Management

    The City of Houston (Houston, TX)
    …of risk management and property & casualty insurance experience + Insurance Adjusters License and property insurance claims experience + Fluent in Microsoft ... alternatives for risk control and/or mitigation. Commercial property insurance claim leader. Establish and coordinate all internal processes, procedures and… more
    The City of Houston (09/04/25)
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  • Risk Manager

    Berkshire Hathaway Automotive (Irving, TX)
    …the Berkshire Hathaway Automotive Headquarters in Irving, TX and report to the Director of Risk Management. Benefits: * Paid training and development * Medical, ... program design, marketing, procurement, and premium allocation. Manage all claims and litigation matters including mediation, involving workers' compensation,… more
    Berkshire Hathaway Automotive (08/29/25)
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  • Physician - Geriatrics Hospital In Home EDRP…

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …administrative and medical issues or concerns to the service medical director . - Participate in the development and implementations of performance improvement ... listed in the job announcement. Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired… more
    Veterans Affairs, Veterans Health Administration (07/31/25)
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