- Centene Corporation (Austin, TX)
- …including a fresh perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical ... implementation of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies… 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
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their… more
- Centene Corporation (Austin, TX)
- …competitive benefits including a fresh perspective on workplace flexibility. **We're Hiring: Remote Medical Directors** Centene Corporation is a leading provider ... quality accreditation standards. + Actively practices medicine **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical … more
- Evolent (Austin, TX)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... improvement, and clinical excellence. + **This position is 100% Remote and can be completed from any state. Multiple...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… 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 relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...overview of coding practices and clinical documentation, grievance and appeals processes (including pharmacy), and reviews for DME, genetic… more
- CVS Health (Austin, TX)
- …day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a ... Fortune 6 company? This is a remote Work at Home position and can be located...anywhere in the United States. In this role as Medical Director MPO ( Medical Policy… more
- Merck (Austin, TX)
- **Job Description** Associate Director , Field Access Management The Associate Director , Field Access Management serves as the leader to a team of subject-matter ... of patient enrollment process, payer coverage policies, prior authorization process, appeals process, patient support programs, and Hub operations to Field Access… more