• Medical Director - Florida

    Humana (Austin, TX)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/29/25)
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  • Medical Director - South Central

    Humana (Austin, TX)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/11/25)
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  • Medical Director - NorthEast Region

    Humana (Austin, TX)
    Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (07/25/25)
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  • Program Mgr UR/Case Management - CMC…

    UTMB Health (Friendswood, TX)
    …trends of inappropriate resource utilization to Director and/or Assistant Director of Utilization Review/Case Management . + Maintains a documentation ... personnel and completes a formal preceptor plan in accordance with Utilization Management Policy 09.04. + Identifies and facilitates quality improvement for the… more
    UTMB Health (08/01/25)
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  • Senior Medical Director (Medicare)

    Molina Healthcare (San Antonio, TX)
    …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures that authorization… more
    Molina Healthcare (06/13/25)
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  • Lead Utilization Management

    Houston Behavioral Healthcare Hospital (Houston, TX)
    Utilization Management Coordinator, Monday-Friday, 8a-4p. The Lead Utilization Management Coordinator will report to the Director of Utilization ... Review and will be responsible to provide quality case management services to all patients and their families, to serve as a member of interdisciplinary team… more
    Houston Behavioral Healthcare Hospital (08/09/25)
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  • Director of Case Management & Social…

    Houston Methodist (Houston, TX)
    …and trends in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information and focuses the ... At Houston Methodist, the Director Case Management & Social Services...appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director more
    Houston Methodist (08/02/25)
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  • Director Case Management

    HCA Healthcare (Arlington, TX)
    …a part of our team. **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and coordinating ... join an organization that invests in you as a(an) Director Case Management ? At Medical City Arlington,...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
    HCA Healthcare (08/09/25)
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  • Remote Medical Director - Texas

    Centene Corporation (Austin, TX)
    …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... Provides medical expertise in the operation of approved quality improvement and utilization management programs in accordance with regulatory, state, corporate,… more
    Centene Corporation (08/02/25)
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  • Medical Director , MSK Surgery

    Evolent (Austin, TX)
    …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
    Evolent (05/20/25)
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