- Providence (TX)
- …communication within the claims team, including other Claims Managers, Claims Reps and Claims Specialists **Maintain complete documentation for each ... **Description** **Senior Professional Liability Medical Claims Manager This position works R** **_emote._** **Many states eligible.** **Providence caregivers are not… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... well as a focus on collaborative business relationships, value-based care, population health , or disease or care management. Medical Directors support Humana values… more
- Centene Corporation (Austin, TX)
- …implementation of recommendations to providers that would improve utilization and health care quality. + Reviews claims involving complex, controversial, ... 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive… more
- Otsuka America Pharmaceutical Inc. (Austin, TX)
- …outcomes, and compliance objectives. + Lead a team of Neuroscience LTC Specialists within an ecosystem to drive appropriate clinical demand and improve patient ... business plans, with a focus on LTC facilities. + Coach Neuroscience LTC Specialists to shape customer plans based on market dynamics to address customer needs… more
- Banner Health (TX)
- …with State Pay Transparency Rules. Innovation and highly trained staff. Banner Health recently earned Great Place To Work(R) Certification (TM) . This recognition ... Find out how we're constantly improving to make Banner Health the best place to work and receive care....A typical day would include overseeing RN denials mgt specialists and Audit team, posting bill reviews, and managing… more
- Molina Healthcare (San Antonio, TX)
- …Looking for a RN that has a current active unrestricted license This a remote role and can sit anywhere within the United States. Work Schedule Monday to ... work on set schedule) Looking for a RN with experience with appeals, claims review, and medical coding. **Job Summary** Utilizing clinical knowledge and experience,… more
- Lincoln Financial (Austin, TX)
- **Alternate Locations:** Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of a commutable distance to an office location. ... be responsible for reviewing, analyzing, and interpreting medical information available for disability claims . In this role you will act as a clinical resource for… more
- Kemper (Dallas, TX)
- …of motions, briefs and other documents. + Communicates with clients, claims adjusters, litigation specialists , attorneys' offices, medical provider offices, ... all records received by case, for attorneys and other claims personnel. + Performs legal research at the request...will be required to work in office, with occasional remote work opportunities. Kemper is proud to be an… more
- Humana (Austin, TX)
- … first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on ... Qualifications** + Medical utilization management experience, + working with health insurance organizations, hospitals and other healthcare providers, patient… more
- Humana (Austin, TX)
- …health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex ... as a focus on collaborative business relationships, value based care, population health , or disease or care management. Medical Directors support Humana values, and… more