• 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • 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)
    - Related Jobs

  • Field Medical Director , Interventional…

    Evolent (Austin, TX)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (07/30/25)
    - Related Jobs