- Prime Therapeutics (Austin, TX)
- …post-degree clinical experience. + Experience in managed care , specialty drugs, care management and utilization review . + Meets Credentialing criteria. ... facility.Discusses financial and clinical considerations with members who are considering care at a higher cost treatment site, researches available financial… more
- Methodist Health System (Richardson, TX)
- …benefits for proposed medical services, to ensure reimbursement for rendered care . This position routinely works with physicians, clinic support staff, case ... managers, nurses, insurance utilization management staff, and patients to initiate pre-authorization and...that require clinical judgment to the Provider, and/or Billing Manager , when necessary. * Advises Manager of… more
- CenterWell (Austin, TX)
- …+ Monitor plan performance and proactively bring issues to the forefront for review + Support new business implementations with a goal of ensuring all pharmacy ... and present to client + Escalate issues for immediate review and action whenever necessary + Request, review...internal partners and the Medicaid market to manage pharmacy utilization and spend + Manage escalated member, client and… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This vacancy will remain open until ... his/her duties under the supervision of the Neuropsychology Program Manager and the Chief of the Medical Specialty Service,...the goals of the El Paso Veterans Affairs Health Care System and to meet the goals of the… more
- Daisy Brand (Garland, TX)
- …enhance KPI and other target settings. + Leverage best practices for asset utilization , care and operation and capitalize on technologies with cross-functional ... training. This role directly reports to the the Packaging Department Manager . The Manufacturing Systems Engineer (Packaging) is responsible for ensuring each… more
- CVS Health (Grand Prairie, TX)
- …your understanding of patient safety and error prevention, quality assurance drug utilization review (DUR), pharmacy professional standards such as corresponding ... of continuous improvement, with the goal of changing health care for the better. **Position Summary:** At CVS Health,...+ Any additional tasks as directed by Supervisor or Manager **Preferred Qualifications:** + 1+ years of related work… more
- Prime Healthcare (Weslaco, TX)
- …to minimize waste, decrease errors, increase efficiency and ultimately improve care and appropriate utilization of informatics to communicate, manage ... for our Performance Improvement and Stroke Program monitors and improves stroke care quality by analyzing data, ensuring compliance with standards, and leading… more
- Sharecare (Austin, TX)
- …individual through the lens of their personal health and making high-quality care more accessible and affordable for everyone. To learn more, visit www.sharecare.com ... in an appropriate, efficient and cost-effective manner while ensuring high quality care . The Disease Management Nurse works with participating members to become… more
- CenterWell (Austin, TX)
- …health first** The LCSW serves as a core member of the Care Integration Team, supporting complex, high-risk patients through proactive psychosocial assessment, ... and influence health outcomes. Ideal experience includes prior work in primary care or working as part of an interdisciplinary team-particularly in partnership with… more
- Houston Methodist (Houston, TX)
- …and/or surgeries), ensure medical necessity compliance, and verify eligibility for care . Other duties for the Clinic Coordinator position include independently and ... and mentoring colleagues though processes in order to provide optimal patient care . Provides structured feedback with examples. + Works with clinical management to… more