- Elevance Health (Houston, TX)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... medical director supports product strategy/design and medical management approaches that impact health care quality,...the medical director provides clinical oversight for Utilization Management , Case Management , and… more
- Centene Corporation (Austin, TX)
- …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory,...coordinate care for high-risk patients, collaborating with care management teams to optimize outcomes. +… more
- Evolent (Austin, TX)
- …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Molina Healthcare (Fort Worth, TX)
- …adjustment, disease management , and evidence-based guidelines. + Experience in Utilization /Quality Program management + HMO/Managed care experience ... resource management . + Develops and implements a Utilization Management program and action plan, which...qualified medical personnel, not influenced by fiscal or administrative management considerations, and that the care provided… more
- Genesis Healthcare (Dallas, TX)
- …department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient identification is overseen ... Director ). 9. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical...Rehab PTA level must have three years direct patient care experience and either one year of management… more
- Ascension Health (Austin, TX)
- …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily market case ... M-F Days + **Location:** Ascension Seton Administrative Offices The Regional Case Management Director has the overall responsibility for managing and… more
- Humana (Austin, TX)
- …Health Medical Director will attend and participate in meetings involving care management , provider relations, quality of care , audit, grievance ... metrics, population health, and disease or care management . The Behavioral Health Medical Director may...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Austin, TX)
- …The Director , Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director ... role, you will be a key enterprise leader, with responsibility for evolving Humana's Utilization Management of medical review by physician or nurse, with a focus… more
- Elevance Health (Grand Prairie, TX)
- **Medical Director -Pain Management /Anesthesia Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required ... accommodation is granted as required by law. The **Medical Director Pain Management /Anesthesia Appeals** is responsible for...to ensure the appropriate and most cost effective medical care is received. May be responsible for developing and… more
- Evolent (Austin, TX)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented... you will be a key member of the utilization management team. We can offer you… more