• Medical Director -- Claims

    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
    Humana (10/29/24)
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  • Medical Director - Florida

    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 (12/14/24)
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  • Reviewing Medical Director

    Conviva (Austin, TX)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
    Conviva (12/11/24)
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  • Medical Director - National Medicare…

    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
    Humana (11/08/24)
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  • Director , Medical Affairs - NYC…

    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
    Merck (12/19/24)
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  • Corporate Medical Director

    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
    Humana (11/27/24)
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  • Director - Market Access Medical

    Caris Life Sciences (Austin, TX)
    **Position Summary** The Director , Market Access Medical Policy is the expert in Caris Life Science Products and their clinical application for the Market Access ... be responsible for developing strategies and value propositions to obtain favorable medical policies for Caris products with payers and laboratory benefit managers.… more
    Caris Life Sciences (12/25/24)
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  • Director Care Management - Aetna…

    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
    CVS Health (12/26/24)
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  • Managing Director - Insurance Advisory…

    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
    EPAM Systems (12/18/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Austin, TX)
    claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
    Baylor Scott & White Health (12/21/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Austin, TX)
    …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
    Takeda Pharmaceuticals (10/16/24)
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  • Regional CM/CEI Practice Director

    Johnson, Mirmiran, and Thompson Inc. (Round Rock, TX)
    …services in Texas. CM services include c onstruction and p rogram management , construction inspection, claims s upport, scheduling and cost estimating, ... 500 Design Firms. JMT is seeking Regional CM/CEI Practice Director for any of our Texas locations. The successful...project controls and other related construction management responsibilities. You will be responsible for driving growth… more
    Johnson, Mirmiran, and Thompson Inc. (10/13/24)
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  • Senior Director of Innovation

    Unilever (Austin, TX)
    The Senior Director of Innovation will direct and oversee all product innovation for Onnit. They will be responsible for collaborating with the CRO to translate the ... new projects. + Develop & execute protocols to ensure positioning, pricing, & claims are optimized for product launches across all channels + Monitor relevant… more
    Unilever (11/24/24)
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  • Director , Provider Contracting - Houston,…

    The Cigna Group (Austin, TX)
    …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical ... This role assists in developing the strategic direction and management of the day to day contracting and network...position. + Creates and manages initiatives that improve total medical cost and quality. + Drives change with external… more
    The Cigna Group (11/15/24)
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  • Coordinator, Intake Utilization Management

    Evolent (Austin, TX)
    …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
    Evolent (12/04/24)
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  • Coordinator, Utilization Management

    Evolent (Austin, TX)
    …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
    Evolent (12/24/24)
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  • Data Visualization Consultant - Remote

    Prime Therapeutics (Austin, TX)
    …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... **Responsibilities** + Under general supervision, analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
    Prime Therapeutics (12/19/24)
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  • Manager, Reporting & Analytics - Remote

    Prime Therapeutics (Austin, TX)
    …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
    Prime Therapeutics (12/18/24)
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  • AVP, Human Resources Business Partner

    SitusAMC (Austin, TX)
    …team! This role is responsible for aligning business goals with employees and management . The position should anticipate HR needs in a proactive manner and ... communicate these requirements and potential solutions to the management team. This position is the HR point of contact for management and employees for their… more
    SitusAMC (12/19/24)
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  • Cloud Solutions Architect Leader

    Sedgwick (Austin, TX)
    …and goals for cloud-based infrastructure services in conjunction with senior IT management . The Director Infrastructure Services - Cloud designs and drives ... This role is responsible for the overall planning and management of the company data center and corporate IT...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
    Sedgwick (10/18/24)
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