- 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 in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… 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 in an ... caring community and help us put health first** The Medical Director relies on medical ...healthcare providers, clinical group practice management . + Utilization management experience in a medical… more
- Molina Healthcare (San Antonio, TX)
- …as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Dental Director is responsible for providing clinical oversight to promote the oral health of the ... of claims, appeals, and potential quality of care issues. The Dental Director - Texas assists in the design, development, and implementation of appropriate… more
- UTMB Health (Webster, TX)
- …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
- Evolent (Austin, TX)
- …for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director in ... , you will be a key member of the utilization management team. We can offer you...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- Centene Corporation (Austin, TX)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... Provides medical leadership of all for utilization management , cost containment, and medical...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Evolent (Austin, TX)
- …setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional cardiology ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management … more
- Molina Healthcare (Fort Worth, TX)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... resource management . + Develops and implements a Utilization Management program and action plan, which...activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +… more
- Elevance Health (Grand Prairie, TX)
- ** Medical Director -Pain Management /Anesthesia Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of ... an accommodation is granted as required by law. The ** Medical Director Pain Management /Anesthesia Appeals**...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more