- 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
- CVS Health (Austin, TX)
- …and consistent responses to members and providers. Leads all aspects of utilization review/quality assurance, directing case management Provides clinical ... the US.** Aetna, a CVS Health Company, has an exciting opportunity for a Medical Director (Spine) that can be remote based, work from home. The Medical Director … more
- Lumen (Austin, TX)
- …future. **The Role** We are seeking a strategic and execution-focused Senior Director of Systems Excellence to lead the implementation and optimization of ... a best-in-class systems infrastructure that supports business operations, asset management , and financial governance. **Location** This is a remote opportunity… more
- Global Foundries (Austin, TX)
- …The g rowing Solution delivery at GLOBALFOUNDRIES seeks a personable and highly motivated SAP Director in Managing a team of FTEs and SI Partners . The role will ... leadership to Cross functional teams Data conversion, Cutover, Testing and Release Management and technical teams, Development , Security & compliance and Basis. +… more
- Molina Healthcare (San Antonio, TX)
- …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... in the performance of prior authorization, inpatient concurrent review, discharge planning, case management and interdisciplinary care team activities. + Ensures… more
- Global Foundries (Austin, TX)
- …test leads, and SMEs Identifies change impacts and coordinates with change management team Supports training activities, as required + Supports the identification ... of industry experience + Teamcenter application experience + Project management skills - ie, the ability to innovate and...information. Requests for accommodation will be considered on a case -by- case basis. Please note that only inquiries… more
- Catholic Health Initiatives (College Station, TX)
- …staff productivity. Serves as the subject matter expert for case management Functions and regulatory compliance for the director and department members. ... have a minimum of Five (5) years experience in Case Management or Care Coordination.** Responsible for...Management a. Serves as a clinical resource for utilization management , compliance for the rules and… more
- HCA Healthcare (Live Oak, TX)
- …care issues. Offers clinical support for appeals and denials process, discharge planning, case management , and utilization review/ management + You ... will consult with facility-level staff regarding delegated utilization management and disease management ...the denial and appeals process, as requested by the Case Management Department and Patient Accounting Services… more
- CenterWell (Longview, TX)
- …performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more
- HCA Healthcare (Webster, TX)
- …services, patterns of care, and utilization of resources. 2. Collaborates with the Director of Case Management to implement policies and procedures to ... Qualifications** POSITION SUMMARY: Under the direct supervision of the Case Management Director , collaborates with...experience in health care delivery systems with focus on Utilization Management & Case … more