- Insmed Incorporated (Houston, TX)
- …of the field-based Field Access team, and will report to the Director , Field Access Managers. This is a non-supervisory position.ResponsibilitiesA key component of ... launch experience preferred Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and coverage policy) Experience… more
- University Medical Center of El Paso (El Paso, TX)
- Job Summary The Director of Strategy Planning and Decision Support is responsible to spearhead El Paso Health's (EPH) strategic planning and to provide leadership to ... UMC's Decision Support processes. Focuses on strategies to position the Medicaid and Medicare Managed Care Organization (MCO) in the El Paso and Hudspeth Region.… 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 ... materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of… more
- Humana (Austin, TX)
- …our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy and/or operations. ... The Behavioral Health Medical Director work assignments involve moderately complex...conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare , Medicare… more
- 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 reviews cases of diverse scope...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Elevance Health (Houston, TX)
- …deliver member-centered, lasting pharmacy care. In this pivotal role on our CarelonRx Medicare Sales and Account Management team, the Pharmacy Account Director ... preserving and deepening relationships with clients which include Elevance Health Medicare Health Plans. This position, structured around geographic regions and… more
- The Cigna Group (Plano, TX)
- …TEXAS market - can live in Houston, San Antonio, Dallas or Plano** The ** Director , Provider Contracting - Medicare ** serves as an integral member of the ... for service and sophisticated value-based reimbursements with providers for Cigna's Medicare product lines (eg, Hospital systems, Ancillaries, and large physician… 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 ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and ...to operationalize this knowledge in their daily work. The Medical Director 's work includes reviewing of all… 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Austin, TX)
- …**Position Summary** CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified ... clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director ( Medical Affairs) will report into… 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 ... will understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to… more
- CVS Health (Austin, TX)
- …and behavioral health programs and services to its membership. Aetna is looking for a medical director to be part of a centralized team that supports the ... related to precertification, concurrent review, and appeal request. The medical director is a work-at-home position located...Two (2) + years of experience in managed care ( Medicare and/or Medicaid) Experience with managed care ( Medicare… more
- CenterWell (Austin, TX)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... caring community and help us put health first** The National Director , Clinical Pharmacy is a strategic...and promote age-friendly care + Maintain current knowledge of pharmacy/ medical trends within ambulatory/primary care and Medicare … more
- Molina Healthcare (Dallas, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... staff services. Maintains a working knowledge of applicable national , state, and local laws and regulatory requirements affecting...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Ascension Health (Austin, TX)
- …**Schedule** :TBA + **Practice** **Detail** : Ascension Texas has an immediate opening for a Medical Director of Population Health who will serve as a member of ... We are seeking to recruit a full time, practicing Medical Director of Population Health to serve...Care Organizations participating in the Enhanced Track of the Medicare Shared Savings Program, multiple commercial value-based models and… more
- CVS Health (Austin, TX)
- …clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health plan Sr Leadership to ... and services for aligned plan's members. Position Description: Aetna Medicare Duals Center of Excellence is searching for a...the delivery of holistic and integrated person-centered care. The Medical Director will be responsible for provider… more
- Magellan Health Services (Dallas, TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead senior medical director , and quality improvement staff. May participate in various ... the health plan(s) for all lines of business (Medicaid, Medicare , and Commercial) and implements programs to support this...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
- Boehringer Ingelheim (TX)
- …expectations for insight generation related to scientific objectives. + In collaboration with Medical Excellence, the MSL Director and TA Sr. AD MSLs, identify ... programs reflect Boehringer Ingelheim's high regard for our employees. The Sr. AD, Medical Science Liaison will manage a regional therapeutic area specific MSL team.… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Director Case Mgmt Social Svcs position is responsible for strategy, function and operations of the Case Management & Social Work ... promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys population-focused teams to enhance… more
- CenterWell (Austin, TX)
- **Become a part of our caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety of medical ... and medical codes (eg, ICD-10-CM, CPT) to patient records. The Director , Medical Coding requires an in-depth understanding of how organization capabilities… more
