- Evolent (Austin, TX)
- …on behalf of our health plans and serves in a supporting role to the Director , Intake and Utilization Management Operations. + This individual will not only lead ... with others. **Collaboration Opportunities:** + The Manager, Client Services oversees daily utilization management and directs the medical care of our members… more
- Humana (Austin, TX)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- Humana (Austin, TX)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (Austin, TX)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The Medical Director … more
- HCA Healthcare (Arlington, TX)
- …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital ... join an organization that invests in you as a(an) Director Case Management? At Medical City Arlington, you come...make a difference. We are looking for a dedicated Director Case Management like you to be a part… more
- Ascension Health (Austin, TX)
- …and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily market ... + **Location:** Ascension Seton Administrative Offices The Regional Case Management Director has the overall responsibility for managing and coordinating case… more
- Molina Healthcare (San Antonio, TX)
- …HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous ... leadership experience + Peer review, medical policy/procedure development, and provider contracting experience + Current clinical knowledge + Experience demonstrating strong management and communication skills, consensus building and collaborative ability, and… more
- UTMB Health (Friendswood, TX)
- … utilization of resources. + Tracks and reports trends of inappropriate resource utilization to Director and/or Assistant Director of Utilization ... quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review/Case Management program by utilizing clinical knowledge, expertise, approved… more
- CenterWell (Austin, TX)
- …part of our caring community and help us put health first** The National Director , Care Integration Strategy & Program will be responsible for the end-to-end program ... will play a pivotal role in reducing acute care utilization for top 5% of complex patients and ensuring...reduction, and other clinical programs as determined. The National Director , Care Integration Strategy & Program is a critical… more
- CVS Health (Austin, TX)
- …use specific crite‐ ria to authorize procedures/services or initiate a Medical Director referral as needed. **Required Qualifications** Must have active, current and ... unrestricted RN licensure in state of residence 3+ years of clinical experience Must be wiling and able to work Monday - Friday 8 am - 5 pm CST with occasional weekend/holiday on-call Position requires proficiency with computer skills which includes navigating… more