• Corporate Medical Director

    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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  • Medical Director ( Medicare )

    Molina Healthcare (Austin, TX)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (05/02/25)
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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 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 (05/14/25)
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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 - Pacific SW Region

    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 (05/10/25)
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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...group practice management. + Utilization management experience in a medical management review organization, such as Medicare more
    Humana (05/14/25)
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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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  • Medical Director Specialty…

    Molina Healthcare (Austin, TX)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
    Molina Healthcare (04/09/25)
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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. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… 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 ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (04/30/25)
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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 ... timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to...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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  • Field Medical Director , Radiology…

    Evolent (Austin, TX)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
    Evolent (03/21/25)
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  • Medical Director , Behavioral Health

    Molina Healthcare (Austin, TX)
    …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
    Molina Healthcare (04/26/25)
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  • Director , Stars HOS Improvement…

    Humana (Austin, TX)
    …our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality rating system evaluates ... Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
    Humana (05/13/25)
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  • Director , Appeals & Grievances (Texas)

    Molina Healthcare (Austin, TX)
    …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
    Molina Healthcare (05/14/25)
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  • Executive Director , Compliance

    NASCO (Austin, TX)
    **Overview** As Executive Director , Compliance you will lead and provide oversight and management of Compliance and Privacy functions and serve as the company's ... Compliance Office. This role will have oversight responsibility for Medicare Advantage and ACA Exchanges strategy and executive relationship responsibility… more
    NASCO (04/16/25)
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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 (03/04/25)
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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 (05/18/25)
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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 (05/16/25)
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  • Director , Employer Group Distribution…

    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 (05/06/25)
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