- Centene Corporation (Austin, TX)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... Management experience strongly preferred. **Position Purpose:** Authorize, direct and monitor care for behavioral health and substance abuse problems according to … more
- Healthfirst (TX)
- …Monitors assigned case load to meet performance metric requirements + Functions as a clinical resource for the multi-disciplinary care team in order to maximize ... State + Department of Health (NYSDOH) regulations governing medical management in managed care + Relevant clinical work experience + Intermediate Outlook, Basic… more
- Molina Healthcare (Houston, TX)
- …other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... (RN) license in good standing. **Preferred Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization… more
- CenterWell (Austin, TX)
- …effective processes within the UM program. Key Responsibilities of a Non- Clinical UM Coordinator: + **Intake and Notification:** Handling initial requests ... team, including scheduling meetings, managing calendars, and preparing presentations. In essence, the non- clinical UM Coordinator acts as a vital link in the … more
- Molina Healthcare (Houston, TX)
- …other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... or a compact licensure. The ideal candidate will have experience with UM and prior authorization, within both Physical Health and Behavioral Health. Candidates… more
- Molina Healthcare (TX)
- …field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies...LPCC or LMFT (for Behavioral Health Care Review Clinicians only). **Preferred Experience** 3-5 years clinical… more
- Molina Healthcare (Fort Worth, TX)
- …other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model + Adheres to UM policies and procedures. + Occasional ... with some weekends and holidays.** Preferred Experience Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization… more
- Molina Healthcare (Fort Worth, TX)
- …of Nursing. Bachelor's Degree in Nursing preferred. **Preferred Experience** 3-5 years clinical practice with managed care , hospital nursing, utilization and/or ... assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term...illness and the site of service. The Lead, HCS ( Clinical ) functions as clinical staff lead in… more
- Prime Therapeutics (Austin, TX)
- …an integral member of our account team. You will be responsible for all clinical products, formulary, and UM strategies.** The Clinical Account Director ... years of relevant work experience in a retail, hospital, clinical and/or managed care setting, including at...$124,000.00 - $211,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Molina Healthcare (Houston, TX)
- …other clinical programs. + Collaborates with multidisciplinary teams to promote Molina Care Model. + Adheres to UM policies and procedures. + Occasional ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care ,… more