• Medical Director - National Medicare

    Humana (Austin, TX)
    …clinical reference materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage ... Advantage and Managed Medicaid. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid,… more
    Humana (07/21/25)
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  • Medicare D Billing Representative

    BrightSpring Health Services (Arlington, TX)
    Our Company PharMerica Overview Join our PharMerica team ! PharMerica is aclosed-door pharmacywhere you can focus on fulfilling the pharmaceutical needs of our ... is service excellence and top-quality care come join our team and apply today! Responsibilities + Act as a...resource to the facilities in obtaining information completing necessary documentation or following up on outstanding claims + Individual… more
    BrightSpring Health Services (07/23/25)
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  • Medical Director - South Carolina SE Region

    Humana (Austin, TX)
    …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare ... group practice management. + Utilization management experience in a medical management review organization, such as Medicare ...May also engage in grievance and appeals reviews. Some medical directors may join a centralized team more
    Humana (07/22/25)
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  • Medical Director - Mid West Region

    Humana (Austin, TX)
    …determinations, clinical reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare ... clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed… more
    Humana (05/14/25)
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  • Physical Therapist - Texas Health Back Care Clinic…

    Texas Health Resources (Southlake, TX)
    documentation within established time frame. + If appropriate, completes all required team documentation including intake process, plan of care, and discharge ... Texas Health so we are Better + Together_** **Spine Team Texas** **Work location:** 1545 E. Southlake Blvd., Suite...for therapy and validates for appropriateness. + Reviews available medical records and obtains pertinent medical history… more
    Texas Health Resources (05/25/25)
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  • Non-Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Austin, TX)
    …and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information Set (OASIS) ... documentation for quality and adherence to policies and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are… more
    BAYADA Home Health Care (07/01/25)
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  • Field Medical Director, Interventional…

    Evolent (Austin, TX)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your ... (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD… more
    Evolent (07/30/25)
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  • Field Medical Director, Cardiology

    Evolent (Austin, TX)
    …(URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...will be a key member of the utilization management team . We can offer you a meaningful way to… more
    Evolent (07/02/25)
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  • Field Medical Director, Oncology

    Evolent (Austin, TX)
    …. Aids and acts as a resource to Initial Clinical Reviewers. . Ensures documentation of all communications with medical office staff and/or MD provider is ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...will be a key member of the utilization management team . We can offer you a meaningful way to… more
    Evolent (05/20/25)
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  • Field Medical Director, MSK Surgery

    Evolent (Austin, TX)
    …+ Aids and acts as a resource to Initial Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is ... the culture. **What You'll Be Doing:** As a Field Medical Director, MSK Surgery you will be a key...will be a key member of the utilization management team . We can offer you a meaningful way to… more
    Evolent (07/04/25)
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