- Molina Healthcare (Houston, TX)
- …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs… more
- MISTRAS Group, Inc. (Houston, TX)
- …rollout of new or amended policies and procedures, advanced technology training + Review and approve field project plans and safety parameters. + Audit post-run ... and shop audits; escalate critical issues to the Senior Director of Operations. + Travel to field locations as...accurate forecasting of projects + Work closely with senior management to implement cost saving actions where directed or… more
- CenterWell (Austin, TX)
- … Director of Physician Strategy at Utilization Management . The Medical Director conducts Utilization review of the care received by members in an ... practice management . + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managedMedicaid, or… more
- 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
- 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...size of region or line of business. The Medical Director conducts Utilization Management of… more
- Elevance Health (Grand Prairie, TX)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and… more
- UTMB Health (Webster, TX)
- Utilization Review Case Mgr - CMC - Clear Lake Center - Compressed weekend night shift Friday - Sunday **Webster, Texas, United States** **New** Nursing & Care ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
- 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
- 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
- Royal Vopak (Deer Park, TX)
- Start your career as a Director of Engineering and Asset Management at Vopak and contribute to social themes such as energy security and energy transition. We ... positive impact? Improve the world and start as a Director of Engineering and Asset Management at...identifying project technical staffing requirements to support projects + Review and validate Project Management plans +… more
