- Elevance Health (Houston, TX)
- ** Medical Director -Dermatology Appeals ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law. The ** Medical Director -Dermatology Appeals ** is responsible for the review of appeals… more
- Elevance Health (Houston, TX)
- **Behavioral Health Medical ** ** Director -Psychiatrist** ** Appeals ** **Location:** This role enables associates to work virtually full-time, with the ... Friday. Half day Saturday rotation, once a month.** The ** Medical Director ** is responsible for the administration...the United States when conducting utilization review or an appeals consideration and cannot be located on a US… more
- Health Care Service Corporation (Richardson, TX)
- …development. **Job Summary** This Position Is Responsible For Assigned Aspects Of Medical Policies And Programs. Performs Medical Appeal Reviews And Interacts ... Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of… more
- Humana (Austin, TX)
- …clinical expertise to review Medicare drug appeals (Part D & B). The Medical director work assignments involve moderately complex to complex issues where the ... case consideration of the Medicare rules, Humana policies and medical necessity. The Medical Director ...includes computer based review of moderately complex to complex appeals for coverage for drugs using resources outlined above… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** The Lead Director , Pharmacy Appeals will lead a team of 40+ colleagues in the management of ... as guiding other internal business units to resolve issues quickly. The Lead Director , Pharmacy Appeals is also responsible for working with the Presidential… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... of service should be authorized at the Initial and Appeals /Disputes level. All work occurs within a context of...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- CenterWell (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health ... claims. The Medical Director , Primary Care work assignments involve moderately complex to...overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- Elevance Health (Houston, TX)
- **Clinical Operations Medical Director ** ** Medical Oncology** **Carelon Medical Benefit Management** **Virtual** : This role enables associates to work ... of clinical domains, including radiology, cardiology and oncology._ The **Clinical Operations Medical Director ** is responsible for supporting the medical … more