- Molina Healthcare (Houston, TX)
- JOB DESCRIPTION **Job Summary** Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal ... years clinical nursing experience, including at least 1 year of utilization review , medical claims review , long-term services and supports (LTSS), claims… more
- UTMB Health (Webster, TX)
- …timeframe and implement measures to achieve target. + Presents LOS variances for review to Director and Inpatient Medical Director. Transfer Center (Hospital to ... monitoring patients with complicated treatment plans through multidisciplinary conferences and medical record review . + Facilitates clinical care progression of… more
- Travelers Insurance Company (Austin, TX)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical review policies. Works in close collaboration with the Claim leaders and in partnership with other … more
- Centene Corporation (Austin, TX)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. + Supports effective implementation… more
- Parexel (Austin, TX)
- …protocol design and drug development programs + Support pharmacovigilance activities including medical review of serious adverse events + Provide risk ... + Review and approve critical study documents including protocols, Medical Monitoring Plans, safety reports, and Informed Consent Forms + Conduct real-time… more
- Kelly Services (Austin, TX)
- …and issues that may occur during studies. + Participate in the development and medical review of recruitment and enrollment strategies and material. + Serve as ... **Senior Medical Director (Principal Investigator)** **Kelly(R) Science & Clinical**...ongoing professional development and conference participation. + Provide thorough review of protocol and other study materials. + Determine… more
- Parexel (Austin, TX)
- …in high quality consultation on protocol development or drug development programs, medical review of various documents, collaboration on internal therapeutic ... Respect, Empowerment & Accountability. **Parexel is looking for a Medical Director with a very strong background in Ophthalmology...very strong background in Ophthalmology to join our Global Medical Sciences team.** **The role can be based remo**… more
- Evolent (Austin, TX)
- …with a focus on **value-based strategy and transformation** . Unlike traditional medical review roles that emphasize volume throughput, this position integrates ... redefining how care is delivered for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal role in… more
- Elevance Health (Houston, TX)
- …an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and supportive care. + Perform ... physician-level case review , following initial nurse review , of chemotherapy regimens. + Determine medical ...nurse review , of chemotherapy regimens. + Determine medical necessity of requests using guidelines and client-specific health… more
- Parexel (Austin, TX)
- …content when contributors provide content that does not meet document needs. + Provide medical editing review of draft and final documents prepared by other ... management with preparation of resourcing estimates for potential new medical writing projects, or review request for...for potential new medical writing projects, or review request for proposal packages to determine content and… more