- Evolent (Austin, TX)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- CenterWell (Dallas, TX)
- …RN license or social work degree / license + 5 years or more prior nursing, case management , disease management and/or social work experience + At least 2 ... managing populations and coordinating care to reduce acute and post-acute care utilization . The Manager role is hybrid with travel requirements to preferred… more
- HCA Healthcare (Houston, TX)
- …five (5) years recent acute care experience required. Minimum of two (2) years of utilization review/ case management experience and minimum of one (1) year ... and overall evaluation of individual patient needs. Care coordination, utilization review and management , as well as...the social worker + Coordinates the integration of social services/ case management functions into the patient care,… more
- Molina Healthcare (TX)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case ...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… 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 ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral… more
- Molina Healthcare (TX)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Austin, TX)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Texas Health Resources (Dallas, TX)
- …to inpatient status if criteria is met. Makes appropriate referrals to Medical Director of Case Management for admission status determinations. Discharge ... Work Preferred * Three years' clinical experience required. * One year of hospital case management experience is preferred. * RN - Registered Nurse Upon Hire… more
- Elevance Health (TX)
- …a State agency.*_ **Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written, ... entire clinical program and/or independently performs clinical reviews. The Medical Director typically has program management responsibilities including clinical… more
- United Airlines (Houston, TX)
- …and renovation projects, system wide. **Job overview and responsibilities** The Director of Corporate Real Estate Planning and Development will oversee a ... are accounted for and addressed. + Portfolio Planning, Development and Management : + Establish and maintain strong business relationships with airport leaders… more