• 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...will focus primarily on review appeal cases for denied medical services. This includes First Level Appeals more
    CVS Health (05/15/25)
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  • Corporate Medical Director

    Humana (Austin, TX)
    … (CMD) relies on medical background to review health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the… more
    Humana (04/24/25)
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  • Medical Director - Medicare…

    Humana (Austin, TX)
    Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse ... scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
    Humana (05/14/25)
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  • Medical Director - Commercial

    CVS Health (Austin, TX)
    …You will participate in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management programs to address ... member needs across the continuum of care. + You will support the Medical Management staff ensuring timely and consistent responses to members and providers. + This… more
    CVS Health (05/15/25)
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  • Medical Director --Claims Management

    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 ... requested site of service should be authorized at the 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
    Humana (05/08/25)
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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...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
    Humana (04/24/25)
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  • Medical Director - Medicaid N.…

    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...managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations,… more
    Humana (05/14/25)
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