- Evolent (Austin, TX)
- …review roles that emphasize volume throughput, this position integrates utilization management with collaborative engagement and innovation. **Core ... for individuals facing cancer. As a Performance Suite Medical Director in Medical Oncology, you will play a pivotal...Responsibilities** + **Clinical Review & Peer Collaboration** + Serve as the physician… more
- Highmark Health (Austin, TX)
- …of internal clinical and value-based evaluation committees that drive formulary and utilization management functions. + Participate in product specific Pharmacy ... of implemented initiatives. + Lead product based pharmacy trend management discussions with internal partners including senior executives. +...and Therapeutics Committees and Drug Utilization Review (DUR) Committees as necessary or… more
- Travelers Insurance Company (Austin, TX)
- …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
- Fresenius Medical Center (Irving, TX)
- …determining project specifications and review methodologies. Analyses will include review of claims data, analysis of medication utilization for global ... the consolidation, analysis and reporting of commercial revenue. Develops standards of review and analysis to facilitate accurate and timely analysis of all… more
- IHG (Houston, TX)
- …full utilization of company systems, business processes and specifications. Review and approve/deny all discount and rebate requests. + Achieve budgeted ... departments. Key departmental contacts include Guest Relations, Accounting, Revenue Management , Sales and Marketing, Catering, Food and Beverage, Housekeeping, and… more
- Elevance Health (Houston, TX)
- …ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review experience is preferred. + Knowledge of the medical ... states; therefore, Multi-State Licensure will be required.** The **Medical Management Nurse** is responsible for review of...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- CVS Health (Austin, TX)
- …management team and utilization management team. The Care Management Associate will review eligibility and benefits and open pre-certification cases ... all with heart, each and every day. **Position Summary** The Care Management Associate (CMA) supports comprehensive coordination of medical services that include… more
- HCA Healthcare (San Antonio, TX)
- …The Manager for Case Management Services reports to the Case Management Director and is responsible for promoting patient-centered care by coordinating ... growth, we encourage you to apply for our Nurse Manager of Case Management opening. We promptly review all applications. Highly qualified candidates will… 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
- CenterWell (Austin, 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