• Program Mgr UR/Case Management - CMC…

    UTMB Health (Friendswood, TX)
    …resource utilization to Director and/or Assistant Director of Utilization Review /Case Management . + Maintains a documentation system of all ... ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review /Case Management program by utilizing clinical… more
    UTMB Health (08/01/25)
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  • Utilization Management Dental…

    Humana (Austin, TX)
    …a part of our caring community and help us put health first** The Dental Director is responsible for providing clinical oversight to promote the oral health of the ... of claims, appeals, and potential quality of care issues. The Dental Director - Texas assists in the design, development, and implementation of appropriate… more
    Humana (08/23/25)
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  • Utilization Review Case Mgr - CMC…

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

    Houston Methodist (Houston, TX)
    …promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys population-focused teams to ... At Houston Methodist, the Director Case Management & Social Services...excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of… more
    Houston Methodist (08/20/25)
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  • Director Client Success

    HCA Healthcare (Frisco, TX)
    …is incentive eligible. **Introduction** Do you have the career opportunities as a Director Client Success you want with your current employer? We have an exciting ... make a difference. We are looking for a dedicated Director Client Success like you to be a part...+ Responsible for team goal achievement related to customer utilization of Valify technology, VSG group purchasing portfolio, power… more
    HCA Healthcare (08/17/25)
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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 (08/20/25)
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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 (08/16/25)
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  • Field Medical Director , Interventional…

    Evolent (Austin, TX)
    …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
    Evolent (07/30/25)
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  • Director of Rehab

    Genesis Healthcare (Dallas, TX)
    …Area Director ). 9. Assumes responsibility for daily staffing and utilization with input from treating therapists, consideration of clinical requirements, and ... of the rehabilitation department, including oversight related to case management , quality improvement, care planning, clinical utilization , and patient… more
    Genesis Healthcare (07/31/25)
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  • Medical Director - Florida

    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...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (07/29/25)
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