- CVS Health (Austin, TX)
- …Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience -Electronic medical systems/record experience -Managed Care ... and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a...at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review… more
- Fresenius Medical Center (Olmito, TX)
- … practices to meet patient needs. + Facilitate the application process for physician privileges and compliance with Medical Staff By-Laws, including assisting ... any governmental or regulatory body having jurisdiction in the premises. Assists the Medical Staff to ensure that medical practices and procedures meets… more
- YesCare Corp (Waxahachie, TX)
- …measures including sentinel event review + Actively participant of the Utilization Review process and follow proper procedures. **YesCare Benefits** (only ... **Experience & Requirements** + Graduate of an accredited medical school. + Fully licensed to practice medicine...staff. + Ensure and provide on-call services. + Annually review and approve clinical protocols, policies and procedures, and… more
- Houston Methodist (Houston, TX)
- …The MA position participates in patient care which is under the direction of a physician and within the scope of a medical assistant. This position may also ... blood pressure, weight, and height), chief complaint(s), preforms medication(s) review , discusses/reviews medical and social history (as appropriate).… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... range of medical clinicians across multiple disciplines (eg medical doctors, nurse practitioners, physician assistants, psychologists, psychiatrists, social… more
- Baylor Scott & White Health (Dallas, TX)
- …guides and facilitates physician /APP relations, recruitment, credentialing and peer/chart review activities. 8. Evaluates new developments in medical care ... vary based on position type and/or level **Job Summary** The Urgent Care Medical Director is responsible for enhancing the planning, overseeing, and directing of … more
- Elevance Health (Grand Prairie, TX)
- …**Carelon Medical Benefits Management** **Post Acute Care Benefit Utilization Management** **Schedule: 10:00-7:00 Central Time** **** **Virtual:** This role ... board certified specialty. + Makes physician to physician calls to gather medical appropriate information...decisions. + Brings to their supervisors attention, any case review decisions that require Medical Director … more
- Houston Methodist (The Woodlands, TX)
- …needs for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use, ... for the hospital. + Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care… more
- Molina Healthcare (San Antonio, TX)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management +… more
- Houston Methodist (Houston, TX)
- …for employee engagement, ie peer-to-peer accountability. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and ... for the hospital. + Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care… more