• 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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  • Director of Patient Safety

    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
    HCA Healthcare (01/04/25)
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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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  • 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 , HIV 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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  • Director , Risk Management

    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
    Western Digital (12/27/24)
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  • Medical Director

    Molina Healthcare (Austin, 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 (01/13/25)
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  • Medicare Grievances and Appeals Corporate…

    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 (01/07/25)
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  • Oncology Regional Medical Scientific…

    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
    Merck (01/10/25)
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  • Director , US Benefits

    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
    Cardinal Health (01/11/25)
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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 (01/04/25)
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  • Director , Medicaid Trend Mitigation…

    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
    Humana (01/08/25)
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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, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
    Baylor Scott & White Health (12/21/24)
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  • Director Client Services

    Sedgwick (Austin, TX)
    …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director Client Services **PRIMARY PURPOSE** : To determine account management more
    Sedgwick (01/07/25)
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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. (01/01/25)
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  • Director , SIU / Fraud Waste and Abuse…

    Molina Healthcare (Austin, TX)
    …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... (SIU) to oversee the special investigations unit vendor outlier analytics and case management system, training and implementation. Serves as a backup for the AVP of… more
    Molina Healthcare (01/13/25)
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  • PBM Sr Business Intelligence Data Visual…

    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 + ... with business partners across client facing divisions, product/ project management , analytics, operations, and IT to enable data-driven strategic decisions.… more
    Prime Therapeutics (01/08/25)
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  • Area Parts and Warranty Manager

    Fun Town RV (Giddings, TX)
    …controls, and supporting the company's growth objectives. Responsibilities: 1. Parts Department Management + Partner with the Director of Parts and Warranty ... enterprise A/R parts, including wholesale company monthly reconciliation. 2. Warranty Department Management : + Partner with the Director of Parts and Warranty… more
    Fun Town RV (12/10/24)
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