- Elevance Health (Grand Prairie, TX)
- …within 50 miles of one of our Elevance Health locations.** The Medical Director is responsible for the administration of physical and/or behavioral health medical ... cost of care opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for an entire clinical program. How you will… more
- Elevance Health (Houston, TX)
- …Shift Hours: **Monday through Friday, 40 hrs a week** . The **Medical Director Associate ( UM )** is responsible for providing day-to-day guidance, support, and ... **Medical Director Associate - Utilization Mgmt.** This is an...and/or quality activities under the guidance of a Medical Director . May be responsible for supporting one or more… more
- Apex Health Solutions (Houston, TX)
- Summary: The UM Reviewer serves as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM ... pending cases for a review determination with Health Solutions Medical Director , coordinate pre-authorization activities with affiliated health plans and interface… more
- Magellan Health Services (Dallas, TX)
- …of care. Provides day to day physician oversight to an assigned interdisciplinary UM team, including regular involvement in the case management of at-risk cases and ... care at the most cost-effective setting. Evaluates the effectiveness of UM practices and criteria. Actively monitors for over- and under-utilization. Assumes… more
- Baylor Scott & White Health (Temple, TX)
- …accountable to provide professional leadership and direction in the utilization/cost management ( UM ) and clinical quality improvement (QI) of the Health Plan, as ... measured by benchmarked UM and QI goals. Works collaboratively as a clinical...care performance. + Partner with Provider Networks and Medical Director team in creating and maintaining programs that incentivize… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Medical Director 's primary responsibility is the review of medical authorizations to determine the medical ... of a given service, level of care, or medical item/supply. The Medical Director 's work assignments involve moderately complex to complex issues where the analysis of… more
- CVS Health (Austin, TX)
- …have a TX License without encumbrances. PM&R Specialty desired. In the Medical Director role you will provide oversight for medical policy implementation. You will ... timely and consistent responses to members and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance… more
- Evolent Health (Austin, TX)
- …a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to ... medical, pharmacy and ancillary claims data, membership data, clinical operational data ( UM & CM), or other healthcare data- **Required.** + Familiarity with Power… more
- Tarleton State University (Stephenville, TX)
- …and relaying feedback and recommendations for programmatic changes to the director . 15% Conduct recruitment presentations at target schools which involves motivating ... funding availability and candidate experience/skillset in relation to the mini m um requirements of this position. Tarleton State University offers a career filled… more
- Tarleton State University (Stephenville, TX)
- …priorities. This position will be located in Stephenville and report to the SON's Director of Curriculum and Instruction. Work hours: Mon-Fri; 8 AM-5 PM or as work ... funding availability and candidate experience/skillset in relation to the mini m um requirements of this position. Tarleton State University offers a career filled… more