• Business Development Director - Casualty…

    Sedgwick (Fort Worth, TX)
    …fulfill those needs. **QUALIFICATIONS** + Ten (10) years of relationship building in the claims management or risk management area or equivalent combination ... Best Workplaces in Financial Services & Insurance Business Development Director - Casualty Claims (TX & OK)...**Experience:** Ten (10) years of relationship building in the claims management or risk management more
    Sedgwick (05/15/25)
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  • Director , Appeals & Grievances (Medicare…

    Molina Healthcare (San Antonio, TX)
    …including 2 years in a manager role. * Experience reviewing all types of medical claims (eg CMS 1500, Outpatient/Inpatient, Universal Claims , Surgery, ... claims , COB and DRG/RCC pricing), and IPA. 2 years supervisory/ management experience with appeals/grievance processing within a managed care setting. **Preferred… more
    Molina Healthcare (07/18/25)
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  • Claims Litigation Manager Senior (Western…

    USAA (San Antonio, TX)
    …truly makes us special and impactful. **The Opportunity** As a dedicated Claims Litigation Manager Senior (Western States), you will responsible for **managing ... resource for colleagues with less experience. + Applies advanced knowledge of claims litigation processes. + Proactively manages litigation and acts as liaison with… more
    USAA (07/10/25)
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  • Medical Director , Global…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …medicines for those with CNS disorders, we are seeking a skilled and experienced Medical Director of CNS Early Assets, Global Medical Affairs, responsible ... , Franchise Lead CNS Early Assets. **Position Summary:** The Medical Director , Global Medical Affairs,...for any assigned assets in development. + Support lifecycle management initiatives and planning for assigned assets as applicable.… more
    Otsuka America Pharmaceutical Inc. (07/16/25)
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  • Medical Director - Florida

    Humana (Austin, TX)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (07/29/25)
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  • Medical Director - South Carolina SE…

    Humana (Austin, TX)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... value based care, population health, or disease or care management . **Responsibilities** The Medical Director provides medical interpretation and… more
    Humana (07/22/25)
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  • Medical Director - NorthEast Region

    Humana (Austin, TX)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
    Humana (07/25/25)
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  • Fraud & Claim Operations Director

    Wells Fargo (San Antonio, TX)
    **About this role:** Wells Fargo is seeking a Fraud & Claims Operations Director to report to the Head of Claims and Recovery. This group is responsible for ... or leadership experience **Desired Qualifications:** + 8+ years fraud and or claims operational management experience supporting large complex organization(s). +… more
    Wells Fargo (07/29/25)
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  • Associate Director , Medical Affairs…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    **Position Summary:** The Associate Director of Global Medical Affairs Omnichannel will be responsible for developing and leading the omnichannel strategy for ... Global Medical Affairs across all therapeutic areas and brands. This...aligning with CoE training efforts + **Performance & Risk Management :** + Provide regular updates on the performance and… more
    Otsuka America Pharmaceutical Inc. (07/15/25)
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  • Medical Director - Medicare…

    Humana (Austin, TX)
    …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with… more
    Humana (07/23/25)
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  • Medical Director

    Molina Healthcare (Fort Worth, TX)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (07/25/25)
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  • Associate Director Brand Analytics

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …The Associate Director is responsible for the design, execution, and management of multiple market research engagements. In addition, the Associate Director ... **Job Summary** The Associate Director of Brand Analytics role for the ecosystem...that deliver exceptional results + Have strong analytical, project management , fiscal management and decision-making skills Have… more
    Otsuka America Pharmaceutical Inc. (07/15/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Austin, TX)
    …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 scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (06/18/25)
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  • Director Patient Safety

    HCA Healthcare (Houston, TX)
    …clinical Patient Safety program, including the functions of clinical Patient Safety, claims management , program administration and Patient Safety education for ... risk reduction. The Director of Patient Safety will participate in the management and support of professional liability litigation at the direction and under the… more
    HCA Healthcare (06/21/25)
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  • Senior Director , Global Clinical…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …medicine and/or clinical pharmacology and associated disciplines (eg biostatistics, data management , medical writing). + An advanced understanding of clinical ... in support of domestic and international clinical development initiatives. The Senior Director , GCD works in a multidisciplinary matrix environment and supports the… more
    Otsuka America Pharmaceutical Inc. (07/16/25)
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  • Director , Specialty Pharmacy Operations

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …Specialty Pharmacy operations for OAPI The position will report to the Executive Director , Channel Strategy and Patient Affordability We are seeking a highly skilled ... and motivated Director of Specialty Pharmacy Operations to lead and oversee...with cross-functional teams, including Brand Marketing, Sales, Patient Access, Medical Affairs, and Regulatory, to integrate pharmacy operations seamlessly… more
    Otsuka America Pharmaceutical Inc. (07/10/25)
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  • Associate Director , Established Brands…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    **_Associate Director , Established Brands Marketing_** **Position Summary** The Associate Director , Established Brands Marketing is responsible for driving ... CNS portfolio. The individual will work closely with market access, sales, medical affairs, and finance to implement commercial strategies that sustain product… more
    Otsuka America Pharmaceutical Inc. (05/16/25)
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  • Senior Director , Federal Government…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    We are seeking a Senior Director , Federal Government Affairs to lead our US federal government engagement in Washington, DC. This position reports to the Vice ... leader, and a member of the Government Affairs Leadership Team, the Senior Director of the Federal Government Affairs will play an integral role in developing… more
    Otsuka America Pharmaceutical Inc. (07/19/25)
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  • Director , Cloud Operations

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …patient outcomes and optimize business processes. **About This Role** The Director , Cloud Operations is responsible for managing, operating, and enhancing our ... and performance in alignment with our growth objectives. The Director will oversee daily operational functions, including infrastructure monitoring, incident… more
    Otsuka America Pharmaceutical Inc. (07/18/25)
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  • Director , Quantitative Pharmacology,…

    Otsuka America Pharmaceutical Inc. (Austin, TX)
    …markets innovative products, with a focus on pharmaceutical products to meet unmet medical needs and nutraceutical products for the maintenance of everyday health As ... a Director , Quantitative Pharmacology, **Clinical Pharmacology,** you will oversee all...on activities related to formulation, development, assay development, sample management , Pharmacogenomics (PGx) and biomarker strategy development. + Train… more
    Otsuka America Pharmaceutical Inc. (07/16/25)
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