- CVS Health (Austin, TX)
- …in the US with virtual training.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health. Founded in 1993, ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- Houston Methodist (Houston, TX)
- …+ Initiates and facilitates referrals for home health care, hospice, and durable medical equipment. Consults with Social Worker Case Manager to assess ... At Houston Methodist, the Case Manager (CM) position is a registered nurse...satisfaction and safety measures. **FINANCE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued… more
- HCA Healthcare (Austin, TX)
- …Nurse Case Manager Rehab opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. **Unlock ... to deliver excellent care patients deserve? At St. David's Medical Center we support our colleagues in their positions....their positions. Join our Team as a(an) Registered Nurse Case Manager Rehab and access programs to assist with… more
- Veterans Affairs, Veterans Health Administration (Laredo, TX)
- …of this announcement for details. Preferred Experience: GS-12 Two years of Medical Social Work/ Case Management experience including experience in working with ... group, and/or family counseling or psychotherapy and advanced level psychosocial and/or case management. (b) Ability to incorporate complex multiple causation in… more
- Elevance Health (Grand Prairie, TX)
- **Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... hours of receipt and meet the criteria._** The **Nurse Case Manager II** is responsible for care management within...management within the scope of licensures for members with complex and chronic care needs by assessing, developing, implementing,… more
- Elevance Health (Houston, TX)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure… more
- Evolent (Austin, TX)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek… more
- Sedgwick (Houston, TX)
- …Place to Work(R) Fortune Best Workplaces in Financial Services & Insurance Bill Review Analyst | Professional Liability | Remote **PRIMARY PURPOSE** : The Bill ... Review Analyst plays a critical role in supporting the medical malpractice claims team by ensuring legal invoice accuracy, compliance, and defensibility. This… more
- Humana (Austin, TX)
- …team and healthcare organization. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, ... quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will...with Case managers or Care managers on complex case management, including familiarity with social… more
- CenterWell (Austin, TX)
- …knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review ... and use of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of… more