- 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
- GuideOne Insurance (Dallas, TX)
- …etc.), submits monthly reports detailing unit activity and results to line of business director and senior claims management as requested. + Responsible for ... to use commonly-used concepts, practices and procedures within the claims and management fields. + Complete formal...and AD&D, long-term disability and short-term disability insurance + Medical , dental and vision plans to meet your unique… more
- HCA Healthcare (Round Rock, TX)
- …healthcare experience. + Minimum of 2 years in risk management , quality, and medical staff experience. + Director and management experience required. + ... dollars to charitable organizations. Apply Today! **Job Summary and Qualifications** The Director of Risk Management is responsible for directing, planning,… more
- Humana (Austin, TX)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Austin, TX)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Merck (Austin, TX)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Guardian Life (Plano, TX)
- …experience is preferred. + Thorough understanding of the dental insurance industry claims management experience, and a substantive knowledge of CDT, policy, ... The **Texas State Dental Director ** will be responsible for ensuring that professional...regulatory audits and if necessary, associated corrective action(s). Expense Management + SP Claims : develop, implement, and… more
- Western Digital (Austin, TX)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
- Waste Connections (The Woodlands, TX)
- ** Director of Risk** Waste Connections is looking for a Director of Risk Management at our Corporate office in the Woodlands, TX! _For those not located in ... company-wide risk. + Manages insurance procurement, develops and implements risk management and compliance policies/procedures, and manages claims and… more
- Molina Healthcare (TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Molina Healthcare (TX)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Austin, TX)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Merck (Austin, TX)
- …needs to support collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, ... **Job Description** Our Medical Affairs team advances patient care by engaging...and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
- Cardinal Health (Austin, TX)
- …and delivers human resource programs and policies, including recruitment, talent management , diversity and inclusion, compensation and benefits, among others. This ... **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the...Benefits to lead and oversee the design, implementation, and management of employee benefit programs. This role will be… more
- Fun Town RV (Fort Worth, TX)
- …of warranty claims to ensure compliance with manufacturer guidelines. + Management of the Warranty managers and administrators ensuring claims are submitted ... Director | Fixed Operations - Corporate Overview: The...Fixed Operations, will be responsible for the oversight and management of the Service, Parts, and Warranty departments within… more
- Catholic Health Initiatives (Houston, TX)
- **Overview** Baylor St. Luke's Medical Center is an internationally recognized leader in research and clinical excellence that has given rise to breakthroughs in ... implemented consistently across the organization. Coordinates requests from the system office claims team related to litigated claims , and collaborates with… more
- AECOM (Dallas, TX)
- …Leads integration of risk/change management processes during delivery, including claims management . + Ensure that project controls measures are implemented. ... select large or complex assignments. + Lead or assist with dispute resolution, claims , and other conflict management issues. + Facilitate planning activities,… more
- CVS Health (Austin, TX)
- …solutions. + Knowledge of the regulations, standards, and policies which relate to medical management . Ability to communicate in a highly effective manner with ... , program operations with core organization-wide business functions including claims , member services, compliance, quality, utilization management , and… more
- Humana (Austin, TX)
- …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… more
- EPAM Systems (Austin, TX)
- …driving strategic and operational excellence across client functions such as underwriting, claims and distribution management . You will contribute to the ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more