- CVS Health (Austin, TX)
- …including post-graduate direct patient care experience specifically. This role expands Aetna's medical management programs to address member needs across the ... continuum of care. In this role you'll support the Medical Management staff ensuring timely and consistent responses to members and providers. You will lead all… 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 required ... for employment, unless an accommodation is granted as required by law. The ** Medical Director Pain Management /Anesthesia Appeals** is responsible for the review… more
- CVS Health (Arlington, TX)
- …services. Promotes communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers, and health ... EST (this will change once they are out of training). As a Care Management Associate you will be supporting comprehensive coordination of medical services… more
- Elevance Health (Grand Prairie, TX)
- …more complex situations. + May be assigned to work special projects relevant to medical call or general medical management policies, practices and procedures ... **Nurse Demand Management ** **Sign On Bonus:$3,000** Carelon Health is a...resources and nursing background to provide callers with appropriate medical information. + Provides caller with appropriate community resources… more
- Evolent (Austin, TX)
- …for utilization management while working in conjunction with the Senior Medical Director. May assist the Senior Medical Director in research ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Humana (Austin, TX)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- Elevance Health (Grand Prairie, TX)
- …people we serve. The medical director supports product strategy/design through medical management that impact health care quality, cost, and outcomes, and ... Director** is responsible for serving as the Operational Medical Director for our care management models for our National Account clients. The medical… more
- Humana (Austin, TX)
- …industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management + Utilization management experience in a medical management review organization, such as Medicare Advantage… more
- Humana (Austin, TX)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- CVS Health (Austin, TX)
- …Holding, Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective ... care management solutions that promote high-quality healthcare for members. We...Use established guidelines to authorize services or escalate to Medical Directors as needed. + Navigate multiple computer systems… more