
This full-time Associate Medical Director role within the Managed Care and Utilization Management department at Texas Children's Health Plan focuses on establishing health plans and medical policies for a top-ranked children's hospital. Key responsibilities include overseeing medical management programs such as discharge planning and case management, conducting evidence-based medical necessity reviews for behavioral health services, and ensuring regulatory compliance with agencies like NCQA and TDI. The position involves collaborating with Chief Medical Officers to develop clinical guidelines, monitoring member outcomes through data analysis, and educating providers on quality standards. The role is appealing due to the opportunity to lead quality improvement initiatives for over 375,000 members and contribute to a mission-driven organization dedicated exclusively to pediatric care.




















