• 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 (10/29/25)
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  • Medical Director - Medicaid Team - FL/SC

    Humana (Austin, TX)
    …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer based review of...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (10/28/25)
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  • Medical Director

    Molina Healthcare (Houston, TX)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/22/25)
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  • Medical Director (AZ)

    Molina Healthcare (Fort Worth, TX)
    … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... IT and data analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory, professional and community… more
    Molina Healthcare (10/17/25)
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  • Field Medical Director - Vascular Surgery

    Evolent (Austin, TX)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
    Evolent (10/10/25)
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  • Field Medical Director , Cardiology

    Evolent (Austin, TX)
    …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
    Evolent (10/01/25)
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  • Texas State Dental Director DHMO

    Guardian Life (Plano, TX)
    …for the functions of utilization management and utilization review , as requested by the Dental Director , Clinical Review . This position ... as needed (eg Specialty Referral Guidelines) with guidance from the Quality and Utilization Management Manager. + Demonstrate expertise in QMP processes and… more
    Guardian Life (10/21/25)
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  • Medical Director - Mid West Region

    Humana (Austin, TX)
    …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned… more
    Humana (09/16/25)
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  • Medical Director , Behavioral Health…

    Molina Healthcare (TX)
    …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management ...all LOBs * Responds to BH-related RFP sections and review BH portions of state contracts * Assist the… more
    Molina Healthcare (10/17/25)
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  • Medical Director (NV)

    Molina Healthcare (TX)
    …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
    Molina Healthcare (10/31/25)
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