- Evolent (Austin, TX)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Highmark Health (Austin, TX)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Austin, TX)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Austin, TX)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Austin, TX)
- … medical management operational improvements, including those within the medical director area + Participate in call rotation + Develop collaborative ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Health Care Service Corporation (Richardson, TX)
- …invest in your professional development. **Job Summary** This position leads all Medical Drug efforts within Enterprise Pharmacy. It sets strategic direction for ... Medical Drug reimbursement, oversees development of Medical Drug fee schedules (across Professional and Facilities), establishes governance and processes to… more
- Elevance Health (Grand Prairie, TX)
- …Accounts Medical Director ** is responsible for serving as the Operational Medical Director for our care management models for our National Account ... we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and… more
- Elevance Health (TX)
- …for an entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management responsibilities ... ** Medical Director ** _Please note that per...**Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written, and… more
- Elevance Health (TX)
- …for an entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management responsibilities ... ** Medical Director ** **Location:** **Virtual -** This role enables associates to work virtually full-time, with the exception of required in-person training… more
- Elevance Health (Houston, TX)
- **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Radiology Benefit Management /Utilization Review** ... granted as required by law._ The **Clinical Operations Associate Medical Director ** is responsible for supporting the... Director ** is responsible for supporting the medical management staff ensuring timely and consistent… more
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