- Highmark Health (Austin, TX)
- …responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using ... Medical Policy criteria sets to evaluate the ... necessity and appropriateness of the requested treatment of service . Depending on the nature of the case, telephonic… more
- Humana (Austin, TX)
- …and Waiver requests. The Medical Director provides medical interpretation and determinations whether services provided by other healthcare ... Humana policies, clinical standards, and (in some cases) contracts. The Medical Director provides medical interpretation and decisions about the… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …Director -Physician) within the Geriatric and Extended Care (GEC) Service . The HBPC Medical Director will provide clinical care within the GEC ... home setting and in other departments within the GEC Service line. In addition to their role as clinician,...audits, and review JC, LTCI, OIG, OMI, and others. Clinical Responsibilities: The HBPC Medical Director… more
- CVS Health (Austin, TX)
- …First Level Appeals / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding, and reimbursement ... of medical management programs through participation in clinical team activities. The Medical Director...providers and facilities to support the effective execution of medical services programs by the clinical… more
- CVS Health (Austin, TX)
- …/ Appeal Hearings / Special Projects and Committee participation when needed. The Medical Director will provide clinical , coding, and reimbursement expertise ... directing case management when necessary. The Medical Director will act as a business and clinical...facilities if needed, to support the effective execution of medical services programs by the clinical… more
- Molina Healthcare (Fort Worth, TX)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. ... and procedures that guide and support the provisions of medical staff services . Maintains a working knowledge...experience, including: + 2 years previous experience as a Medical Director in a clinical … more
- HCA Healthcare (Weatherford, TX)
- …Healthcare Pathology Services and their North Texas Division is seeking a Pathology Medical Director to be based at Medical City Weatherford in ... CP Board Certification required + 2 years of hospital-based Medical Director experience preferred + Recent experience...staff represents more than 31 medical specialties. Medical City Weatherford's comprehensive health care services … more
- HCA Healthcare (Mckinney, TX)
- …Healthcare Pathology Services and their North Texas Division is seeking a Pathology Medical Director to be based at Medical City McKinney in McKinney, ... Texas. HCA Healthcare Pathology Services employs over 200 board certified multispecialty pathologists nationwide...CP Board Certification required + 2 years of hospital-based Medical Director experience preferred + Recent experience… more
- CenterWell (Arlington, TX)
- …our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, ... , financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and...Operations Director and/or Market President) and Shared Services partners to align on clinical and… more
- Texas A&M University System (College Station, TX)
- …CPR, AED, Bloodborne Pathogens, licensure requirements, etc.). + Works closely with Medical Oversight/ Clinical Program Director to ensure abnormal research ... environment. The Research Nurse Coordinator/Manager, operating under the direction of the Clinical Program Director , is responsible for the planning, organizing,… more
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