- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at… more
- Evolent (Austin, TX)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Physical Medicine and Rehab you will be a key member of the ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
- Molina Healthcare (Austin, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. + Experience… more
- Sedgwick (Austin, TX)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr. VP Medical Director **PRIMARY PURPOSE** **:** To evaluate medical reports ... review process including making a recommendation of specialty for the Independent Medical Review process. + Developing and delivering training materials and… more
- Baylor Scott & White Health (Mckinney, TX)
- …may vary based on position type and/or level **Job Summary** Looking for an experienced medical director to lead our palliative care practice at Baylor Scott & ... White Medical Center - McKinney. The medical director will manage the day-to-day operations...Hospital lead for Palliative Care Consultation Services + Develop, review , maintain and execute ongoing multi-year Strategic Plans for… more
- Molina Healthcare (Dallas, TX)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review... medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in… more
- CenterWell (Fort Worth, TX)
- …a part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- CenterWell (Arlington, TX)
- …a part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... (clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical… more
- CVS Health (Houston, TX)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides clinical expertise and… more
- Molina Healthcare (Houston, TX)
- …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... committees for quality compliance. * Implements clinical practice guidelines and medical necessity review criteria * Tracks all clinical programs for BH quality… more