- CVS Health (Austin, TX)
- …Qualifications** + 1+ years current or previous experience in Home Health. + and/or Case Management experience preferred . + 1+ years experience with Lexicomp a ... This position consists of working intensely as a telephonic case manager with patients and their care team for...team for fully and/or self-insured clients. + Enhancement of Medical Appropriateness and Quality of Care: + Application and/or… more
- Highmark Health (Austin, TX)
- …+ 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice) ** Preferred ** + 1 year in Medical Management in a Health Insurance Plan; ... standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical...Preferred ** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... or data requires an in-depth evaluation of variable factors. Candidate must have valid Florida Medical license and must be able to start with 30-60 days of hire. The… more
- Datavant (Austin, TX)
- …for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to ... ICD-9-CM, ICD-10-CM, and ICD-10-PCS codes + Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentation… more
- Humana (Austin, TX)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. The ... Behavioral Health Medical Director work assignments involve moderately complex to complex...participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post-acute… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- Summary The Medical Supply Technician (Sterile Processing) provides sterilization, high level disinfection (HDL), preparation, supply items and reusable medical ... sterilization, high level disinfection (HDL), preparation, supply items and reusable medical equipment decontamination and distribution support for the medical … more
- Elevance Health (Houston, 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** **Interventional Pain** **Carelon Medical ...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 + ... dynamic, highly motivated, and experienced individual for the position of **Associate Medical Director.** The Associate Medical Director will provide hands-on… 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