• Medical Director - National

    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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (06/25/25)
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  • Medical Director - Medicare

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
    Humana (04/24/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims and ... preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
    Humana (06/18/25)
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  • Senior Medical Director

    Molina Healthcare (Austin, TX)
    …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
    Molina Healthcare (06/13/25)
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  • Principal Data Scientist - Aetna Medicare

    CVS Health (Austin, TX)
    …We are looking for a Principal Data Scientist to join our Aetna Medicare (STARS Portfolio) team at CVS Health. This high-level individual contributor will partner ... closely with the Executive Director of Aetna STARS Analytics to drive hands on...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
    CVS Health (05/29/25)
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  • Medical Director - Care Plus…

    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...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (04/24/25)
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  • Medical Director - OneHome

    Humana (Austin, TX)
    …of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
    Humana (05/31/25)
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  • Medical Director - Mid West Region

    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 (05/14/25)
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  • Medical Director -Payment Integrity

    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 (06/06/25)
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  • Medical Director , MSK Surgery

    Evolent (Austin, TX)
    …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (05/20/25)
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  • Director , Compliance - Specialty…

    Humana (Austin, TX)
    …part of our caring community and help us put health first** The Director of Regulatory Compliance develops and implements compliance programs aimed at governmental ... requirements and regulations across Humana Specialty and Military products. The Director manages dedicated compliance teams of associates who oversee compliance… more
    Humana (06/14/25)
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  • Field Medical Director , Cardiology

    Evolent (Austin, TX)
    …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (05/16/25)
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  • Field Medical Director

    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 ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
    Evolent (04/30/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Austin, TX)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (06/06/25)
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  • Field Medical Director , Oncology

    Evolent (Austin, TX)
    …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... recorded in a timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
    Evolent (05/20/25)
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  • Field Medical Director

    Evolent (Austin, TX)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management… more
    Evolent (06/11/25)
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  • Medical Director - Commercial…

    CVS Health (Austin, TX)
    …have Internal Medicine or Internal Medicine/Pediatrics (Med/Peds) Board Certification. In the Medical Director role, you will provide oversight for medical ... and consistent responses to members and providers. As a Medical Director you will focus primarily on...medical license. Internal Medicine background Have experience in Medicare and Medicaid **Education** *M.D. or DO, Board Certification… more
    CVS Health (06/14/25)
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  • Associate Medical Director

    Evolent (Austin, TX)
    …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
    Evolent (06/03/25)
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  • Director of Infection Prevention

    HCA Healthcare (Austin, TX)
    …HCA Healthcare colleagues invested over 156,000 hours impacting our communities. As a(an) Director of Infection Prevention with St. David's North Austin Medical ... is devoted to giving! **Benefits** St. David's North Austin Medical Center, offers a total rewards package that supports...vary by location._** Come join our team as a(an) Director of Infection Prevention. We care for our communities… more
    HCA Healthcare (06/21/25)
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  • Division Director of Research GME

    HCA Healthcare (Austin, TX)
    …This position is incentive eligible. **Job Summary and Qualifications** HCA Graduate Medical Education is one of the nation's largest providers of residency and ... is building a leading network of innovative, patient-centered graduate medical education programs. We believe graduate medical ...nearly 8,000 by 2028. The Central/ West Texas Division Director of Research Administration will lead a team of… more
    HCA Healthcare (06/21/25)
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