- Highmark Health (Austin, TX)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Molina Healthcare (Austin, TX)
- …**Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental ... management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management ...all LOBs * Responds to BH-related RFP sections and review BH portions of state contracts * Assist the… more
- Molina Healthcare (San Antonio, TX)
- …learn new programs. Preferred Qualifications * Experience with utilization /quality program management . * Managed care experience. * Peer review experience. * ... of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies… more
- Evolent (Austin, TX)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Molina Healthcare (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
- Humana (Austin, TX)
- …management + Utilization management experience in a medical management review organization such as Medicare Advantage, managed Medicaid, or Commercial ... community and help us put health first** The Medical Director relies on broad clinical expertise to review...with prior experience participating in teams focusing on quality management , utilization management , or similar… more
- Elevance Health (Houston, TX)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... **Clinical Operations Medical Director ** **Medical Oncology** **Carelon Medical Benefit Management...any case review decisions that require Medical Director review or policy interpretation. **Minimum Requirements:**… more
- Humana (Austin, TX)
- …providers. + Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed Medicaid, or Commercial ... + Demonstrate adaptability and willingness to learn evolving workflows, tools, and utilization management practices **Work Schedule Monday - Friday w/standard… more
- Evolent (Austin, TX)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Radiology you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Texas Tech University (Lubbock, TX)
- …space utilization & faculty collaboration. Participate in periodic space review analysis & research productivity reviews for WCOE facilities. Work with other ... **42844BR** **Extended Job Title:** Senior Director , Engineering Research Facilities **Position Description:** Manages and...in a fiscally responsible manner. Essential Functions: + Facilities Management - Work closely with WCOE & TTU personnel to… more