- Eisai, Inc (Houston, TX)
- …US healthcare system across one or more major payer segments (Medicare, Medicaid , Federal, and Commercial).Experience working with medical and pharmacy benefits, ... At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides...individual contributor reporting into the Eisai Access and Reimbursement team under Patient Services/Market Access. Working closely with and… more
- 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...of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical … more
- Humana (Austin, TX)
- …to adapt and the courage to innovate **Additional Information** Reports to the Lead Medical Director - North Central Medicaid Markets. The Medical ... caring community and help us put health first** The Medical Director relies on medical ...Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and… more
- CVS Health (Austin, TX)
- …"Work from Home" position primarily supporting Aetna Better Health of Texas. The Medical Director is part of a centralized team that supports the Medical ... 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… more
- Humana (Austin, TX)
- …party reporting including notification, collection, analyze, storage, and distribution. + Team representative and presenter for various Medicaid committee ... caring community and help us put health first** The Associate Director , Procurement generates and implements efficient sourcing and category management strategies.… 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 ... and will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all submitted medical … more
- Humana (Austin, TX)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture** + **Knowledge and experience with national guidelines… more
- Humana (Austin, TX)
- …home health, SNF, DME, dual Medicare/ Medicaid and Waiver requests. The Medical Director provides medical interpretation and determinations whether ... caring community and help us put health first** The Medical Director relies on fundamentals of CMS...consistency in outcomes, consumer experiences, and a highly engaged team culture + Knowledge and experience with national guidelines… more
- Humana (Austin, TX)
- …and related tasks; works under minimal supervision; and assists in supporting the medical director team and leaders in meeting enterprise-wide business ... community and help us put health first** The Corporate Medical Director (CMD) relies on medical...+ Knowledge of the managed care industry including Medicare, Medicaid and/or Commercial products + Must be passionate about… more
- Evolent (Austin, TX)
- …meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Austin, TX)
- …for 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 . We can offer you a meaningful way to...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- 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 ... team . We can offer you a meaningful way to...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
- Molina Healthcare (Dallas, TX)
- …3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization/Quality Program management + ... Medical License without restrictions (free of sanctions from Medicaid or Medicare) **PREFERRED EDUCATION:** Master's in Business Administration, Public Health,… more
- Evolent (Austin, TX)
- …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... will be a key member of the utilization management team . We can offer you a meaningful way to...Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- HCA Healthcare (San Antonio, TX)
- …**_Note: Eligibility for benefits may vary by location._** Come join our team as a Director of Finance. We care for our ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...analyses to solve complex operational and financial problems. The Director assists the Parallon Executive team and… more
- CVS Health (Pearland, TX)
- …**_**Candidate must reside in Texas**_** **Position Summary** + The Lead Director , Provider Engagement manages and oversees compliance with our Provider Engagement ... responsibilities as provided within the State Medicaid contractual requirements. + This role is responsible for...not limited to CRM. + Manages Local Provider Engagement Team to Deploy National Engagement Model. + Responsible for… more
- HCA Healthcare (San Antonio, TX)
- …**_Note: Eligibility for benefits may vary by location._** Come join our team as a Payment Resolution Director . We care for our ... We care like family! Jump-start your career as a Payment Resolution Director today with Parallon. **Benefits** Parallon offers a total rewards package that… more
- Methodist Health System (Dallas, TX)
- …performance related to quality, clinical outcomes and patient safety to the medical staff, hospital staff, and administration. The Director is responsible ... :** **Work Shift :** **Job Description :** Your Job: Job Purpose: The Director Clinical / Quality Management is responsible for conducting assessments of medical… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Director , IT Portfolio Management & Agile Services collaborates with the business portfolio team ... instill enterprise-wide adoption of Agile methodologies and practices. The Director requires an in-depth understanding of how organizational capabilities interrelate… more
- Elara Caring (Conroe, TX)
- …make a real difference by carrying out our mission every day. Join our elite team of healthcare professionals, providing the Right Care, at the Right Time, in the ... Right Place. **Job Description:** **Branch Director - Hospice** At Elara Caring, we care where...they are on their health journey, we care. Each team member has a part to play in this… more
