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UnitedHealth Group
San Antonio, TX, United States
Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as
Job Source: UnitedHealth GroupUnitedHealth Group
San Antonio, TX, United States
Opportunities at WellMed , part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us a
Job Source: UnitedHealth GroupUnitedHealth Group
San Antonio, TX, United States
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start **Caring. Connecting. Growing together.** The **Behavioral Medical Director** position is responsible for providing oversight to and direction of the Ut
Job Source: UnitedHealth GroupAmerican Association of Equine Practitioners
Cibolo, TX, United States
Medical Director Lead Our Growing Practice in Cibolo, TX Ultimate Work-life balance: 8-5, no nights, no weekends, no on-call, and we are closed during lunch hours! Are you a passionate, experienced veterinarian looking for an opportunity to truly make your mark?Our established veterinary practice in Cibolo, Texas is searching for a new leader to ta
Job Source: American Association of Equine PractitionersDirect Jobs
San Antonio, TX, United States
Towne North Animal Hospital located in San Antonio, TX is looking for an experienced Veterinarian to join our practice as a Medical Director. Established in 1984, Towne North Animal Hospital is a progressive, well-equipped small animal hospital located in north central San Antonio, TX. We are a full service hospital with a high focus on dental car
Job Source: Direct JobsPremise Health
San Antonio, TX, United States
Premise Health is seeking a full time Medical Director for our employer based direct care clinic in San Antonio What makes this opportunity unique: Practice evidence based medicine where you are not paid for production Bottom line is measured by the quality of patient care A work life balance that is not just promised A collaborative approach with
Job Source: Premise HealthOptum
San Antonio, TX, United States
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and incl
Job Source: OptumOptum
San Antonio, TX, United States
About the Company: Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by
Job Source: OptumSan Antonio, TX, United States
About the Role
Evry Health is hiring a tech-savvy Medical Director to lead medical policy and utilization management. As a physician, you will work with the actuarial, technology, medical care coordination, and medical quality management teams. You will report directly to the Chief Medical Officer.
About Evry Health and Globe Life
We are on a mission to bring humanity to health insurance. Our high-technology health plans expand benefits, increase access and transparency, and feature a personalized, human approach. We strive to ensure members live happier, healthier lives.
Globe Life has recently acquired Evry Health. Globe Life (NYSE:GL) has 16.8 million policies in force, and more than 3,000 corporate employees and 15,000 agents. For more than 45 consecutive years, Globe Life has earned an A (Excellent) rating or higher from A.M. Best Company.
Key Responsibilities
Utilization management.
Medical policy.
Leading, and working with, the Utilization Management Review Committee.
Development of new medical policies.
Incorporating regulatory updates, and care guideline updates into medical policy.
Medical oversight, expertise and leadership to ensure the delivery of cost effective, quality healthcare services to health plan members.
Promote positive relations with the local medical community, including periodic consultation with providers, facilities, care givers, etc.
Reviews case management data, identifies trends and gaps in care and recommends corrective actions.
Provides oversight and direction for staff and provider training and education.
Integration of clinical quality and demonstrated best clinical practices into medical management program development. Evaluates the development of new and continuation of existing programs. Investigates future care management and patient engagement technologies and evaluates their impact on providers’ practices, patient safety and patient experience.
Qualifications
Active Texas (TX) medical license.
A degree as a Medical Doctor is required, with 4+ years of clinical experience in the practice of medicine.
Must have at least 2 years experience working within a health insurance plan, with an emphasis on population health.
Board certification in a medical specialty recognized by the American Board of Medical Specialists. Current state license as a MD without restrictions, limitations or sanctions from government programs.
Experience in managed care and utilization management.
Knowledge of managed care systems, quality improvement and clinical acumen.
Experience performing utilization management within a health plan.
Experience with MCG or other care guidelines.
Telecommuting Requirements
Required to have a dedicated work area established that is separate from other living areas and provides information privacy.
Ability to keep all company sensitive documents secure.
Must live in the United States.
Must live in a location that receives an existing high-speed internet connection/service.
Location and Benefits
This is a remote position. Our whole company works remotely. Company headquarters are in Dallas, Texas.
Company business hours are weekdays 9-5 CST. Medical staff have alternating shifts weekends 9-noon CST.
Full benefits package including health insurance, 401(k) matching, vision, dental, life, disability, and vacation.
Employment Status
Full time - Salary.
Minimum Required Education
A degree as a Medical Doctor is required.
Experience
4+ years of clinical experience in the practice of medicine. Management experience preferred. Experience working within a health insurance plan is required.
To Apply
Please attach your resume when submitting through this LinkedIn posting.
The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description. Evry Health is an EEO employer (see https://www.eeoc.gov/sites/default/files/2022-10/EEOC KnowYourRights screen reader 10_20.pdf)
Email Alert for REMOTE: Medical Director, Utilization Management and Medical Policy jobs in San Antonio, TX, United States
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