- CVS Health (Houston, TX)
- At CVS Health , we're building a world of health around...by meeting consumers where they want to be met in home or over the phone. The HFSR will own the ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...well as resolving any issues with respect to the utilization of the product. The position will be a… more
- Evolent (Austin, TX)
- **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health ... care, we seek to connect the pieces of fragmented health care system and ensure people get the same...Nurse, you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent (Austin, TX)
- …experience and as an RN - **Required** + Minimum of 5 years in Utilization Management, health care Appeals, compliance and/or grievances/complaints in a quality ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies… more
- Community Health Systems (Laredo, TX)
- …Bachelor's Degree in Nursing preferred + 2-4 years of clinical nursing experience in a hospital, home health , or nursing home setting required + 2-4 years of ... to assess the appropriateness of admission, continued hospital stay, and utilization of diagnostic services. + Collaborates with interdisciplinary teams (IDT) to… more
- Catholic Health Initiatives (Tomball, TX)
- …be responsible for hiring positions in area of responsibility. 10. Monitors utilization of staff and supplies in assigned areas, and recommends appropriate ... to stay withinbudget guidelines while constantly improving the quality of health care. 11. Monitors compliance with policies, implements plans and recommends… more
- Catholic Health Initiatives (Lake Jackson, TX)
- …care and services of patients across the continuum of illness; promote effective utilization ; monitor health care resources; and assume a leadership role with ... License **Licensure/Certifications:** Registered Nurse (RN) license **Overview** St. Luke's Health -Brazosport Hospital is located on a beautiful, 25-acre campus in… more
- Catholic Health Initiatives (Houston, TX)
- …of the critical pathway, and collaborating with the entire team to control LOS, ICU utilization and document variances. + Serve as a clinician in the care of this ... be self-motivated + Effective problem solving techniques **Overview** CommonSpirit Health was formed by the alignment of Catholic ...across the US & from clinics and hospitals to home -based care and virtual care services CommonSpirit is accessible… more
- Humana (Austin, TX)
- …and web navigation skills **Desired Qualifications** + Master's degree in health -or business-related field + Utilization management experience (Commercial and/or ... part of our caring community and help us put health first** The Senior Market/Industry Insights Professional works closely...an evidence based medicine review process. **Location:** work at home anywhere Humana is seeking a Senior Clinical Policy… more
- HCA Healthcare (Dallas, TX)
- … health adjustment. + Coordinates effective discharge plan arranging for home health /outpatient follow up treatments and networks with appropriate community ... **Benefits** Medical City Dallas, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more
- Catholic Health Initiatives (Bryan, TX)
- …required, obtaining pre-certification reference number, approved length of stay, and utilization review company contact person and telephone number 13. Notify ... requirements that may be inherent in position. **Overview** CommonSpirit Health was formed by the alignment of Catholic ...across the US & from clinics and hospitals to home -based care and virtual care services CommonSpirit is accessible… more