- Datavant (Austin, TX)
- Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the ... attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Elevance Health (Grand Prairie, TX)
- … medical necessity decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director review or policy ... **Clinical Operations Associate Medical Director** **Carelon Medical Benefits Management**...make an impact:** + Ensures timely completion of clinical case reviews for their board certified specialty. + Makes… more
- Sumitomo Pharma (Austin, TX)
- …FDA and/or EU ICH safety requirements** + Expertise in medical review of medical review of Individual case safety reports and aggregate safety reports + ... Sumitomo Pharma Co., Ltd. is a global pharmaceutical company based in Japan with key operations in...motivated, and experienced individual for the position of **Associate Medical Director.** The Associate Medical Director will… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D ... & B). The Medical director work assignments involve moderately complex to complex...where the analysis of situations or data requires a case -by- case consideration of the Medicare rules, Humana… more
- Globus Medical, Inc. (San Antonio, TX)
- Bone Bank Allografts, a subsidiary of Globus Medical Inc., specializes in processing and distributing high-quality bone allografts for various medical ... renowned engineering, drives our mission to advance patient care and medical innovation through precise and efficient allograft processing and distribution.… more
- Providence (TX)
- …to address coverage + Set appropriate indemnity and expense reserves + Select appropriate medical experts for case review + Develop a plan of action for ... must empower them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, evaluate, and manage professional,… more
- Elevance Health (TX)
- …external entities and/or serve on internal and/or external committees. + May chair company committees. + Interprets medical policies and clinical guidelines. + ... ** Medical Director** _Please note that per our policy...and external physicians. + May conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers… more
- CVS Health (Austin, TX)
- …a remote based (work at home) based anywhere in the US.** Aetna, a CVS Health Company , has an exciting opportunity for a Medical Director (Spine) that can be ... **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs… more
- Houston Methodist (Sugar Land, TX)
- …decisions and is accountable for reviewing denials for level of care, medical necessity, and as appropriate, DRG recoupments/downgrades, and denials for no ... stakeholders. The Senior Denials Management Specialist position collaborates with physicians, case managers, and payors to ensure appropriate utilization of … more
- Select Medical (Dallas, TX)
- …Institute for Rehabilitation - Dallas Downtown** A joint venture with Select Medical & Baylor Scott & White Health Dallas, TX **Admissions Coordinator** ... Are** **Inpatient Rehabilitation Hospital is a joint-venture partnership between Select Medical and . This hospital provides inpatient physical rehabilitation for… more