- 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...work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference… more
- Molina Healthcare (Austin, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... state, and local laws and regulatory requirements affecting the medical and clinical staff. + Marketplace UM ...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- CVS Health (Austin, TX)
- …do it all with heart, each and every day. **Position Summary:** Ready to take your Medical Director skills to the next level with a Fortune 6 company? Checkout ... Jersey, New York, Ohio, Oklahoma, Pennsylvania, Texas, Virginia and West Virginia. This Medical Director will be a "Work from Home" position primarily supporting… more
- CVS Health (Austin, TX)
- …a Texas License without encumbrances or willing to obtain a Texas License. In the Medical Director role you will provide oversight for medical policy ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...and consistent responses to members and providers. As a Medical Director you will focus primarily on… more
- 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
- CVS Health (Austin, TX)
- … UM experience with a Health plan/payor experience. *Electronic medical systems/record experience *Managed Care experience *Board certification in Internal ... Health Company, is one of the oldest and largest national insurers. That experience gives us a unique opportunity...in the development, implementation, and evaluation of clinical / medical programs and expand Aetna's medical management… more
- Centene Corporation (Austin, TX)
- …one who changes everything for our 28 million members. **Position Purpose:** Chief Medical Director , Product provides strategic and clinical leadership to the ... related field preferred. 7+ years relevant experience required. Previous experience as Medical Director preferred. Board Certification through American Board of … more
- Evolent (Austin, TX)
- …Tasks are performed within the RN/LVN/LPN scope of practice, under Medical Director direction, using independent nursing judgement and decision-making, ... that do not meet established clinical criteria to the Medical Director . + Appropriately identifies and refers.... + Appropriately identifies and refers quality issues to UM Leadership. + Appropriately identifies potential cases for Care… more