• Director Utilization

    Texas Health Resources (Arlington, TX)
    Director Utilization Management -Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking ... leader for system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes and delegates activities… more
    Texas Health Resources (10/16/25)
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  • Utilization Review Case…

    UTMB Health (Webster, TX)
    Utilization Review Case Mgr-CMC-Clear Lake Center; M-F, 3:00 PM - 11:00 PM **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
    UTMB Health (10/22/25)
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  • Senior Director Case Management

    Houston Methodist (Houston, TX)
    …strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is ... At Houston Methodist, the Sr Director Case Management position is responsible...initiatives. + Provides strategic vision and execution for case management and utilization review across… more
    Houston Methodist (10/16/25)
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  • Director Case Management & Social…

    Houston Methodist (Houston, TX)
    …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... At Houston Methodist, the Director Case Management & Social Services...in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information… more
    Houston Methodist (08/20/25)
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  • Medical Director - Claims Management

    Humana (Austin, TX)
    …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately..., depending on the line of business. The Medical Director conducts Utilization Management or… more
    Humana (11/01/25)
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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 ... utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality… more
    Evolent (09/25/25)
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  • National Accounts Medical Director

    Elevance Health (Grand Prairie, TX)
    …members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the clinical ... the medical director is directly involved in Utilization Management and Case Management ....state or territory of the United States when conducting utilization review or an appeals consideration and… more
    Elevance Health (09/23/25)
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  • Remote Behavioral Medical Director - Texas

    Centene Corporation (Austin, TX)
    …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management...Performs medical review activities pertaining to utilization review more
    Centene Corporation (10/15/25)
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  • Remote Medical Director - Texas

    Centene Corporation (Austin, TX)
    …functions for the business unit. + Provides medical leadership of all for utilization management , cost containment, and medical quality improvement activities. + ... on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management...Performs medical review activities pertaining to utilization review more
    Centene Corporation (08/14/25)
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  • Medical Director - Medicaid N. Central

    Humana (Austin, TX)
    …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately...Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of… more
    Humana (10/25/25)
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