- Humana (Austin, TX)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Austin, TX)
- **Become 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...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Austin, TX)
- …Information** Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Austin, TX)
- …the Medicare Line of Business. **Additional Information** Typically reports to Lead or Corporate Medical Director , depending on size of region or line of ... caring community and help us put health first** The Medical Director actively uses their medical...reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and … more
- Humana (Austin, TX)
- …adapt and the courage to innovate **Additional Information** Typically reports to a Lead, or Corporate Medical Director , depending on size of region or line ... caring community and help us put health first** The Medical Director relies on medical ...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Governmental Reporting is responsible for ensuring that Houston Methodist meets all internal and external financial and ... governmental reporting requirements. Requirements include Medicare cost reports, Federal Tax Returns Health and Human Services (HHS)/Centers for Medicare and… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Director , Employer Group Distribution is responsible for leading a field-based team who sells ... to clients of all sizes within an assigned Group Market. The Director is responsible for leading business relationships with employer group clients, brokers,… more
- Humana (Austin, TX)
- …caring community and help us put health first** The Associate Director ; Software Renewals establishes and implements hardware and software acquisition, protection, ... procedures that are aligned with IT standards and strategy. The Associate Director ; Software Renewals requires a solid understanding of how organization capabilities… more
- Molina Healthcare (Houston, TX)
- …the state health plan. Works with direct management, senior leadership/management, Corporate , and staff to develop and implement standardized provider contracts and ... and Joint Operating Committees. * Manages and reports network adequacy for Medicare , Marketplace, and Medicaid services. * In conjunction with direct management and… more
- Banner Health (TX)
- …Banner Health the best place to work and receive care. Banner - University Medical Center Phoenix has been recognized on the Becker's Hospital Review 2025 "Great ... part of your Total Rewards package. Within Banner Health Corporate , you will have the opportunity to apply your...to achieve objectives such as Annual Initiatives, Centers for Medicare and Medicaid Services (CMS) and The Joint Commission… more
- Fresenius Medical Center (Olmito, TX)
- …minutes. + Provide support to the Medical Executive Committee as requested by the Medical Director and in accordance with the Medical Staff Bylaws. + ... regulatory body having jurisdiction in the premises. Assists the Medical Staff to ensure that medical practices...within the community. Minimal travel to regional, Division and Corporate meetings may be required as well. + The… more
- Fresenius Medical Center (Olmito, TX)
- …minutes. . Provide support to the Medical Executive Committee as requested by the Medical Director and in accordance with the Medical Staff Bylaws. . ... regulatory body having jurisdiction in the premises. Assists the Medical Staff to ensure that medical practices...within the community. Minimal travel to regional, Division and Corporate meetings may be required as well. . The… more
- Centene Corporation (Austin, TX)
- …for appeals, adjustments and miscellaneous/unlisted code review + Review cases with Medical Director to validate decisions and identify opportunities to create ... medical records, claims history, state regulations, contractual obligations, corporate policies and procedures and guidelines established by the American … more
- Humana (Austin, TX)
- …caring community and help us put health first** **Clinical Business Lead, Humana Medicare Advantage** As Regional Clinical Business Lead, you serve as a key member ... clinical strategy, performance monitoring, and continuous quality improvement within the Medicare Advantage program to support improving the health of members. The… more
- Humana (Austin, TX)
- …clinical strategy, performance monitoring, and continuous quality improvement within the Medicare Advantage program to support improving the health of members. The ... the Regional Vice President of Health Services (RVP) and Health Services Director (HSD) . This position focuses on enabling connections with providers, supporting… more
- AdventHealth (Mansfield, TX)
- …Manager is under the general leadership of the Care Management Facility Director and has the responsibility of the departmental daily operations and supervision ... responsible for, but not limited to: Coordination of Care, Centers for Medicare & Medicaid Services (CMS) Conditions of Participation, Social Services implementation… more