• Medical Director - Care Plus…

    Humana (Austin, TX)
    …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... of decisions to internal associates, and possible participation in care management . The clinical scenarios predominantly arise...with prior experience participating in teams focusing on quality management , utilization management , case … more
    Humana (06/28/25)
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  • Medical Director - NorthEast Region

    Humana (Austin, TX)
    …depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an assigned ... with prior experience participating in teams focusing on quality management , utilization management , case ...business metrics. + Experience working with Case managers or Care managers on complex case management , including… more
    Humana (07/25/25)
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  • Utilization Management Dental…

    Humana (Austin, TX)
    …is accomplished by analysis and adjudication of claims, appeals, and potential quality of care issues. The Dental Director - Texas assists in the design, ... Medicaid dental programs preferred **Additional Information** o The Dental Director conducts clinical reviews of the care ...Dental Director conducts clinical reviews of the care received by members in an assigned market, member… more
    Humana (08/23/25)
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  • Utilization Review Case Mgr - CMC - Clear…

    UTMB Health (Webster, TX)
    …cost and efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning ... - CMC - Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2504557 The mission of Correctional… more
    UTMB Health (08/21/25)
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  • Director Case Management & Social…

    Houston Methodist (Houston, TX)
    …trends in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information and focuses the ... care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director ...utilization of resources to avoid denials and resource management as it pertains to delivery of care… more
    Houston Methodist (08/20/25)
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  • Field Medical Director , Pain…

    Evolent (Austin, TX)
    …Clinical Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... for selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical… more
    Evolent (08/20/25)
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  • Director of Patient Care Services

    UTMB Health (League City, TX)
    Director of Patient Care Services **League City, Texas, United States** Executive - Nursing & Patient Care UTMB Health Requisition # 2504009 **Summary:** The ... Director of Patient Care Services is accountable for the quality and efficiency of patient care services provided, the management of allocated resources,… more
    UTMB Health (08/01/25)
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  • Director of Critical Care ICU

    HCA Healthcare (San Antonio, TX)
    …**Introduction** Do you want to join an organization that invests in you as a(an) Director of Critical Care ICU? At Methodist Hospital Stone Oak, you come first. ... make a difference. We are looking for a dedicated Director of Critical Care ICU like you...a day, with full accountability, for the staffing and management of patient care in each of… more
    HCA Healthcare (07/12/25)
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  • Director Case Management

    HCA Healthcare (Arlington, TX)
    …external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all aspects of daily hospital case ... our team. **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for...(LMSW), required + 3+ years' experience in overall acute care Hospital Case Management , preferred + 2+… more
    HCA Healthcare (08/09/25)
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  • Physician - Community Based Clinics, Value Based…

    UTMB Health (Friendswood, TX)
    Physician - Community Based Clinics, Value Based Care Director **Friendswood, Texas, United States** **Hot** Physician UTMB Health Requisition # 2502256 **JOB ... the standards of the institution. The Community Based Clinic (CBC) Community Value Base Care Director will collaborate with the UTMB Health Directors and School… more
    UTMB Health (07/19/25)
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