• Hospitalist Medical Director - Houston…

    Houston Methodist (Sugar Land, TX)
    … medical school; board certified in Internal Medicine or Family Medicine. + Texas medical license or eligibility to obtain one. + Minimum 5 years of clinical ... Land is seeking a dynamic and experienced physician leader to serve as the ** Medical Director of the Hospitalist Program** . This individual will be responsible for… more
    Houston Methodist (08/02/25)
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  • Senior Denials Mgmt Specialist

    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
    Houston Methodist (07/31/25)
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  • Medical Appointments Coordinator

    BrightSpring Health Services (Denton, TX)
    …to apply today! Responsibilities + This position will compile, process, and maintain medical records, of person(s) served in a manner consistent with medical , ... as coordinated by Registered Nurse supervisor + Monitor triage reportsMaintain medical records according to are regulatory requirements + Maintain all diagnostic… more
    BrightSpring Health Services (07/16/25)
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  • Medical Director - OneHome

    Humana (Austin, TX)
    …MD or DO degree + Current and ongoing board certification in an approved ABMS Medical Specialty + A current and unrestricted license in at least one jurisdiction ... and willing to obtain license , as required, for various states in region of...national guidelines such as NCD/LCD, MCG(R) or InterQual The Medical Director conducts clinical case reviews of… more
    Humana (07/15/25)
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  • Care Manager - Behavioral Health

    Molina Healthcare (Austin, TX)
    …* Must have active behavioral health license * 2+ years in case management, disease management, or medical or behavioral health settings. * Experience ... who must live and have a current active unrestricted license in the state of TX (LMSW, LCSW, LMFT,...the state of TX (LMSW, LCSW, LMFT, and/or LPC) Case Manager will work remotely supporting Medicaid Behavioral health… more
    Molina Healthcare (07/20/25)
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  • Nurse Navigator - Urology ( Medical Center)

    Houston Methodist (Houston, TX)
    …maintains relationships with community organizations, interprofessional departments and outside medical service agencies to help coordinate support services for ... Licensure -- Compact Licensure - Must obtain permanent Texas license within 60 days (if establishing Texas residency) **AND**...PREFERRED** + Magnet - ANCC Recognized Certification (ANCC) -- Case Management related **OR** + ACM - Accredited … more
    Houston Methodist (05/21/25)
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  • Social Worker II - PRN

    Houston Methodist (Houston, TX)
    …treatment outcomes and affect positive patient and family outcomes. This position uses case management skills to help patients and their families address and resolve ... to their health condition. The SW II position holds joint accountability with case manager, assuring that psychosocial and continuing care issues are addressed and… more
    Houston Methodist (05/13/25)
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  • Chief Medical Officer - Texas

    Centene Corporation (Austin, TX)
    …who changes everything for our 28 million members. **Position Purpose:** Provide medical oversight, expertise and leadership to ensure the delivery of cost ... + Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is...including periodic consultation with providers or prescribers. + Review case management data, identifies trends and gaps in care… more
    Centene Corporation (07/16/25)
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  • Field Medical Director, Interventional…

    Evolent (Austin, TX)
    …non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology ... to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better health outcomes in an… more
    Evolent (07/30/25)
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  • Senior Social Worker (HUD/Vash) - Edrp Approved

    Veterans Affairs, Veterans Health Administration (Abilene, TX)
    …Senior Social Worker: provides clinical support, assists in program development, provides shared case load support, and manages a case load of Veterans receiving ... Health Information and Technology Architecture (VISTA) to access information in the Medical Center Computer System. Is responsible for key project activities related… more
    Veterans Affairs, Veterans Health Administration (07/10/25)
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