- Prime Healthcare (Weslaco, TX)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/219738/manager-of-health-information- management medical ... Overview Knapp Medical Centeris a 227-bed not-for-profit, acute care hospital,...TRAINING + Must be knowledgeable regarding the Health Information Management Department process and its application and evaluation of… more
- Molina Healthcare (TX)
- …provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management , Network, and other departments to enable critical decision ... projects related to medical cost reduction initiatives + Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to… more
- Molina Healthcare (Austin, TX)
- …provider reimbursement changes + Provide data driven analytics to Finance, Claims, Medical Management , Network, and other departments to enable critical decision ... to medical cost reduction initiatives and budgeting same + Support Medical Management by assisting with Return on Investment (ROI) analyses for vendors to… more
- Centene Corporation (Austin, TX)
- …services to health plan members. + Serves as clinical advisor to and educator of medical management staff making sure correct clinical judgment is applied to all ... medical management determinations. + Provide leadership and expertise in the development, implementation and interpretation of medical review and quality… more
- Travelers Insurance Company (Austin, TX)
- … capabilities to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon ... **What Is the Opportunity?** Lead the strategy and operations of Travelers Claim Medical initiatives focusing on how developments in the broader medical … 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
- Elevance Health (Houston, TX)
- …**Clinical Operations Associate Medical Director** is responsible for supporting the medical management staff ensuring timely and consistent medical ... **Clinical Operations Associate Medical Director** **Interventional Pain** **Carelon Medical Benefits Management ** **Virtual:** This role enables associates… more
- CVS Health (Austin, TX)
- …Neurosurgery, including post-graduate direct patient care experience specifically. Expands Aetna's medical management programs to address member needs across the ... continuum of care. Supports the Medical Management staff ensuring timely and consistent responses to members and providers. Leads all aspects of utilization… more
- CVS Health (Austin, TX)
- …Texas. The Medical Director is part of a centralized team that supports the Medical Management staff and may support other health plans as needed. The ... Review Organization a Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience -Electronic medical systems/record… more
- 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