- 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 (Austin, TX)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health ... and waiver requests. The Medical Director provides medical interpretation and determinations whether services provided...providers, clinical group practice management . + Utilization management experience in a medical management… more
- 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 ... procedures, and guidelines that ensure appropriate and effective utilization of healthcare services + Evaluates BH utilization management team performance and… more
- Kelsey-Seybold Clinic (Houston, TX)
- …and seeing patients for follow up visits, assisting these patients with the medical management of their disease. + Managing narcotics, narcotic agreements, ... **Job Summary:** Kelsey-Seybold's Pain Management Center is actively recruiting a Physician Assistant...1949 by Dr. Mavis Kelsey in Houston's renowned Texas Medical Center. More than 850 physicians and allied health… more
- 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
- 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
- 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. + ... 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
- 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 (Houston, 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...providers and facilities to support the effective execution of medical services programs by the clinical teams.… more