- Elevance Health (Cleveland, TX)
- …the identification, evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and long term ... co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and accurate member history… more
- CenterWell (Austin, TX)
- …short-term interventions, and connection to community-based resources. This role brings behavioral health expertise and addresses social determinants of ... of an interdisciplinary team-particularly in partnership with primary care teams, community health workers, pharmacists, and behavioral health specialists.… more
- Highmark Health (Austin, TX)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more
- Highmark Health (Austin, TX)
- …**JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most ... URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …but not limited to: amputation, paralysis, neurological disorders, orthopedic conditions, behavioral health , psychiatric diagnoses, dementia, spinal cord injury, ... assessed needs and preferences in recreation therapy. Document patient's behavioral observations, progress, functioning, and intervention outcomes. Develop and… more
- Molina Healthcare (TX)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... disorders. * Approves prior authorization requests for BHT treatment by reviewing Behavioral Health Therapy (BHT) assessments and treatment plans for medical… more
- Highmark Health (Austin, TX)
- …agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees. ... designs, competitive position, product development, network options, strategic partnerships, utilization review, local/national client demographics and dentist distribution. Interpret… more
- HCA Healthcare (Houston, TX)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Texas, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved… more
- HCA Healthcare (Live Oak, TX)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Northeast, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care… more
- CenterWell (Houston, TX)
- …Care Integration Team Manager is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high ... that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more… more