- Molina Healthcare (Houston, TX)
- …BH peer reviews and appeals * Supports BH committees for quality compliance . * Implements clinical practice guidelines and medical necessity review criteria * ... Tracks all clinical programs for BH quality compliance with NCQA and CMS * Assists with the...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- CenterWell (Austin, TX)
- …, Informatics** will be responsible for supporting Patient Safety analytics on the Medicare population. The Associate Director is expected to perform and present ... community and help us put health first** The Associate Director , Informatics coordinates with other analytics, IT and business...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Director , Employer Group Distribution is responsible for leading a field-based team who sells ... to clients of all sizes within an assigned Group Market. The Director is responsible for leading business relationships with employer group clients, brokers,… more
- Baylor Scott & White Health (Austin, TX)
- **Job Summary** The Director , Denial Resource Center is responsible for the strategic planning, evaluation, and operational oversight of the clinical denial ... management function for Baylor Scott and White Health (BSWH). The Director , Denial Resource Center will lead a highly skilled team of Registered Nurses, Certified… more
- Cognizant (Dallas, TX)
- **Healthcare Payer BPaaS Sales Director ** **Job Summary** We are seeking a highly experienced **Healthcare Payer BPaaS Sales** ** Director ** with 15 to 20 years ... and recommendations to senior management for strategic decision-making. + Ensure compliance with industry regulations and company policies in all sales activities.… more
- CenterWell (Fort Worth, TX)
- …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, combining ... indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals *Personally… more
- CenterWell (Arlington, TX)
- …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, combining ... indicators (KPIs), such patient experience via Net Promoter Score (NPS) and Medicare clinical quality via HEDIS, meeting local and organizational goals + Personally… more
- Health Care Service Corporation (Richardson, TX)
- …financial reporting functions. HSB is a profitably growing division selling Medicare Supplement and other Supplemental Health and Life products. Current annual ... and implement reserving/financial processes to coincide with new product and Medicare Supplement charter launches. * Own and execute Sarbanes-Oxley controls and… more
- Humana (Austin, TX)
- …and help us put health first** Humana is seeking a forward-thinking Associate Director for Human Resources Technology to join our HRIT leadership team. In this ... performance, data integrity, and security through rigorous governance and proactive compliance practices. + Build a best-in-class HR data and analytic platforms… more
- Molina Healthcare (Houston, TX)
- …health portions of state contracts. * Assists behavioral health medical director lead trainers in the development of enterprise-wide education on psychiatric ... reviews and appeals. * Supports behavioral health committees for quality compliance . * Implements behavioral health specific clinical practice guidelines and medical… more