• Medical Director -Musculoskeletal…

    Evolent Health (Austin, TX)
    …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Medical Director for the Musculoskeletal department, you will be a key member of ... complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of...questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into… more
    Evolent Health (09/10/24)
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  • Medical Director - Medicare

    Molina Healthcare (Dallas, TX)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... **JOB DESCRIPTION** **Job Summary** Responsible for serving as the primary liaison between administration and medical staff....experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (11/02/24)
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  • Medical Director , BH - TX licensed,…

    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 ... + Participates in and maintains the integrity of the appeals process, both internally and externally. Responsible for the...committees or project teams as directed by the senior medical director or vice-president. + Supports senior… more
    Magellan Health Services (08/21/24)
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  • Medical Director , Medicaid (Remote…

    Highmark Health (Austin, TX)
    … Doctor or Doctor of Osteopathic Medicine (DO) + Board certification in a primary medical specialty + Active, unrestricted medical state licensure required. ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
    Highmark Health (08/23/24)
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  • Physician Clinical Reviewer, Hematology…

    Evolent Health (Austin, TX)
    …recorded in a timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to the Utilization Management ... complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of...request and provides clinical rationale for standard and expedited appeals . + Utilizes medical /clinical review guidelines and… more
    Evolent Health (10/04/24)
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  • Cardiology Physician Clinical Reviewer

    Evolent Health (Austin, TX)
    …on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization ... complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of...support. + On a requested basis, may function as Medical Director for selecting health plans or… more
    Evolent Health (08/29/24)
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