- Citigroup (Irving, TX)
- Enterprise Risk Analytics is a part of the Enterprise Risk Management (ERM) organization at Citi, and is, among other commitments, broadly responsible for end-to-end ... by the Firm's risk identification. Results Analytics Lead is responsible for the review of results across ERM-owned risk metrics: stress loss, stress loss limits' … more
- Fluor (Houston, TX)
- …assessments of current technologies to determine their continued usefulness, utilization , and identify improvement opportunities. * Makes decisions independently on ... tool. * Submit new HSE technology requests to the Fluor IT Governance Review Committee. * Submit budgetary estimates for annual financial planning purposes. **Basic… more
- BAYADA Home Health Care (Austin, TX)
- …+ Candidates should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...and procedures. As a member of the Medicare Case Management (MCM) office, individuals in this role are expected… more
- Molina Healthcare (TX)
- …Degree in Behavior Analysis or a related field. **Preferred Experience** Utilization Management experience Health Plan/MCO work experience **Preferred License, ... requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide...Director , and Senior Medical Directors to ensure proper management of the BHT benefit * Up to 30%… more
- Catholic Health Initiatives (College Station, TX)
- …2. Clinical Management a. Serves as a clinical resource for utilization management , compliance for the rules and regulations for government, non-government ... productivity. Serves as the subject matter expert for case management Functions and regulatory compliance for the director...plans. 3. Monitoring of departmental goals a. Collaborates with Director and staff to implement, monitor and review… more
- Evolent (Austin, TX)
- …sources to establish and maintain the definitive source of truth for specialty Utilization Management (UM) agreements. This important work is achieved through ... Minimum 3 years of professional experience in value-based healthcare analytics or utilization management within a payer, provider, clinical vendor, managed care,… more
- CenterWell (Longview, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... delivery, and documentation requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking for performance … more
- AdventHealth (Burleson, TX)
- …and completes Talent Care accordingly. + Assist with overseeing clinical teams to review utilization and options for product selection. + Assist Director ... **The role you'll contribute:** The Senior Clinical Resource Manager reports to the Director of Strategic Clinical Resource Management and Value Analysis. The… 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 ... of quality and cost improvement, and develops systems to review utilization of resources and objectively measure...consult with facility-level staff regarding delegated utilization management and disease management … more
- Parsons Corporation (San Antonio, TX)
- …Protections Director with administrative tasks related to the Scientific Review Board (SRB) and Human Research Protections Program (HRPP). The role involves ... Unit - San Antonio (NAMRU-SA) and its collaborating institutions in the management of research programs. NAMRU-SA's mission is to improve survival, operational… more