- Humana (Austin, TX)
- …put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
- CVS Health (Austin, TX)
- …ensuring timely and consistent responses to members and providers. As a Medical Director you will focus primarily on review appeal cases for denied ... / Pediatrics (Med / Peds) Board Certification. In the Medical Director role, you will provide oversight...eg, Clinical Practice and Health Care Industry. *Prior UM ( Utilization Management) experience *Active and current state medical… more
- Elevance Health (Grand Prairie, TX)
- …to their supervisors attention, any case review decisions that require Medical Director review or policy interpretation. **Minimum Requirements:** + ... **Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule:… more
- Houston Methodist (Houston, TX)
- …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... most clinically appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- HCA Healthcare (Dallas, TX)
- …colleagues invested over 156,000 hours impacting our communities. As a Division Director of Clinical Informatics with North Texas Division Office, you can be ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...by location._** Come join our team as a Division Director of Clinical Informatics. We care for our communities… more
- Molina Healthcare (San Antonio, TX)
- …Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous ... Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review... medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** **REQUIRED EDUCATION:** * Doctorate Degree in… more
- CVS Health (Austin, TX)
- …anywhere in the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The ... Medical Director (Spine) will be a Subject...responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides… more
- Highmark Health (Austin, TX)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may… more
- HCA Healthcare (Austin, TX)
- …satisfaction and personal growth, we encourage you to apply for our Assistant Director Supply Chain opening. We promptly review all applications. Highly ... care like family! Jump-start your career as a(an) Assistant Director Supply Chain today with St. David's South Austin... Supply Chain today with St. David's South Austin Medical Center. **Benefits** St. David's South Austin Medical… more