• Medical Director-Pain Management

    Elevance Health (Grand Prairie, TX)
    …/Anesthesia Appeals** is responsible for the review of appeals for physical health medical services , to ensure the appropriate and most cost effective ... ** Medical Director-Pain Management /Anesthesia Appeals** **Location:** This role enables associates to work virtually full-time, with the exception of required… more
    Elevance Health (08/21/25)
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  • Medical Director, Clinical Services

    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. + ... outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan;...**Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral &… more
    Highmark Health (07/29/25)
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  • Medical Director - Care Plus - Florida

    Humana (Austin, TX)
    …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
    Humana (06/28/25)
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  • Behavioral Health Medical Director…

    Humana (Austin, TX)
    …industry including Medicare Advantage and Managed Medicaid products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization,… more
    Humana (08/09/25)
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  • Medical Director - NorthEast Region

    Humana (Austin, TX)
    …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... other healthcare providers, clinical group practice management . + Utilization management experience in a medical management review organization,… more
    Humana (07/25/25)
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  • National Accounts Medical Director

    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...the clinical relevance to account reporting regarding use of medical services by members. Involved in identifying… more
    Elevance Health (08/27/25)
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  • Remote Medical Director- Texas

    Centene Corporation (Austin, TX)
    …changes everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national ... Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions... medical review of complex, controversial, or experimental medical services , ensuring timely and quality decision… more
    Centene Corporation (08/16/25)
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  • Manager of Health Information Management

    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,...Foundation. Located in Weslaco, TX, we provide exceptional healthcare services to residents of the Mid- Valley. Knapp works… more
    Prime Healthcare (08/11/25)
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  • VP & Medical Director

    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
    Travelers Insurance Company (07/25/25)
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  • Chief Medical Officer - Texas

    Centene Corporation (Austin, TX)
    … 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
    Centene Corporation (08/27/25)
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