• Field Medical Director, Interventional Cardiology…

    Evolent (Austin, TX)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
    Evolent (04/30/25)
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  • Chief Medical Officer

    HCA Healthcare (El Paso, TX)
    …a data-driven environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care in ... support for appeals and denials process, discharge planning, case management, and utilization review /management + You will consult with facility-level staff… more
    HCA Healthcare (04/23/25)
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  • Medical Director (Medicare)

    Molina Healthcare (Austin, TX)
    … management, risk management, risk adjustment, disease management, and evidence- based guidelines. + Experience in Utilization /Quality Program management ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
    Molina Healthcare (05/02/25)
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  • Field Medical Director, Cardiology

    Evolent (Austin, TX)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Director you will be a key member of the utilization management team. We can offer you a meaningful...the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
    Evolent (02/14/25)
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  • Divisional Director of Care Management, Strategy…

    CenterWell (Austin, TX)
    …consistent and standardized program workflows, dyad communication/partnership, and quarterly business review of acute care and post-acute care utilization . + ... and coordinating care to reduce acute and post-acute care utilization . The Divisional Director role is a hybrid with...organization. This must include the ability to drive a team- based approach and work as an interdisciplinary team to… more
    CenterWell (05/04/25)
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  • Field Medical Director, Radiology (Endocrinology)

    Evolent (Austin, TX)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Radiology you will be a key member of the utilization management team. We can offer you a meaningful...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
    Evolent (05/03/25)
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  • Field Medical Director, Pain Management

    Evolent (Austin, TX)
    … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... Management, you will be a key member of the utilization management team. We can offer you a meaningful...the regulatory timeframe of the request. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
    Evolent (04/12/25)
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  • Appeals Licensed Practical Nurse

    Evolent (Austin, TX)
    …business needs of the particular health plan. * Research requests for post-determination review and categorizes each for processing based on the applicable ... You Bring:** + 1-3 years' experience in clinical Appeals Review or Utilization Management Review ...all employees have the following technical capability at their home : High speed internet over 10 Mbps and, specifically… more
    Evolent (05/10/25)
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  • ServiceNow Knowledge Analyst - US Based…

    Anywhere Real Estate (San Antonio, TX)
    …product managers, engineers, and business owners to ensure effective management and utilization of knowledge assets. You will ensure that Anywhere maintains the ... Oversee all stages of the knowledge management lifecycle, including creation, review , publication, and retirement of knowledge assets. + **Collaboration:** Partner… more
    Anywhere Real Estate (04/12/25)
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  • Clinical Reviewer, Physical Therapy

    Evolent (Austin, TX)
    …call center staff. Initial clinical reviewers are supported by Physician clinical review staff (MDs) in the utilization management determination process. **What ... Therapy you will be a key member of the utilization management team. We can offer you a meaningful...outcomes. **Collaboration Opportunities: ** + Functions in a clinical review capacity to evaluate all cases, which do not… more
    Evolent (05/08/25)
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