- Highmark Health (Austin, TX)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Humana (Austin, TX)
- …reports to the Lead Medical Director . **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Humana (Austin, TX)
- …reports to the Lead Medical Director .** **Other duties:** + Identify medical management operational improvements, including those within the medical ... part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home… more
- Centene Corporation (Austin, TX)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Centene Corporation (Austin, TX)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Evolent (Austin, TX)
- …accountability for utilization management while working in conjunction with the Senior Medical Director . May assist the Senior Medical Director ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...process. + On a requested basis, may function as Medical Director for selecting health plans or… more
- CenterWell (Austin, TX)
- …Information** Will report to the Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care ... **Become a part of our caring community and help us put health first** The Medical Director , Primary Care relies on medical background and reviews health… more
- Humana (Austin, TX)
- …relationships, value-based care, quality metrics, population health, and disease or care management . The Behavioral Health Medical Director may develop ... our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations.… more
- Humana (Austin, TX)
- …to the Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- HCA Healthcare (Austin, TX)
- …multiple facilities along with Corporate Meetings in the Nashville, TN area. The Director of Graduate Medical Education is responsible for maintaining oversight ... the administrative operations and maintain appropriate oversight and daily management of all medical education programs, which...benefits may vary by location._ We are seeking a(an) Director of Graduate Medical Education for our… more
- Humana (Austin, TX)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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 … more
- Humana (Austin, TX)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- CVS Health (Austin, TX)
- …cover urgent cases can be done from your laptop. **Fundamental Components:** * Utilization management - The medical director will perform concurrent and ... services to its membership. Aetna is looking for a medical director to be part of a...be part of a centralized team that supports the Medical Management staff ensuring timely and consistent… more
- Humana (Austin, TX)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Merck (Austin, TX)
- **Job Description** The Oncology Regional Medical Scientific Director , Oncology is a credentialed (ie, MD, PhD, PharmD, or DNP) therapeutic and disease expert ... claims about any drug, vaccine or biologic product. The Oncology Regional Medical Scientific Director provide to Scientific Leaders balanced, factual, scientific… more
- 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 to ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- CVS Health (Austin, TX)
- …day. **Position Summary** Aetna, a CVS Health company, has an outstanding opportunity for a Medical Director . Ready to take your career to the next level with a ... anywhere in the United States. In this role as Medical Director MPO ( Medical Policy...providing clinical expertise and business direction in support of medical management programs to promote the delivery… more
- Merck (Austin, TX)
- …partnership with Precision Medicine Health Systems Oncology Medical Affairs Director (PM HSO-MADs), oncology account management , and precision medicine teams ... This role also serves as a resource for the Medical Affairs (MA) management team on strategic...resource for the PM MAD-HSO Team Lead, HSO Executive Director Medical Affairs, and other members of… more
- Evolent (Austin, TX)
- …non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... utilization management while working in conjunction with the Senior Medical Director . **Qualifications** + MD/DO/MBBS Degree + Current, unrestricted clinical… more
- Merck (Austin, TX)
- **Job Description** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD, DO) Vaccines/Infectious Disease expert who engages in ... from SLs, including questions about Company products. The work of a Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more