- Highmark Health (Austin, TX)
- …and walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization Management Knowledge : A strong understanding of utilization ... walkthroughs. + ** Utilization Management & Clinical Expertise:** + Utilization Management Knowledge : A strong understanding of utilization … more
- Healthfirst (TX)
- … management including preauthorization of outpatient or inpatient services + Knowledge of utilization management /quality management case philosophies ... **Duties/Responsibilities:** + Oversees utilization management functions which include timely...settings for high risk, complex populations + Certified Case Manager + Interqual, Milliman, and/or TruCare knowledge … more
- Houston Methodist (The Woodlands, TX)
- …payer requirements/issues, and eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , ... determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- Elevance Health (San Antonio, TX)
- …and personalized support throughout the consumer's treatment journey. **Title:** Utilization Management Representative II - Prior Authorization **Location:** ... immediate support. **Build the Possibilities. Make an extraordinary impact.** The ** Utilization Management Representative II - Prior Authorization** is… more
- Houston Methodist (Sugar Land, TX)
- …to ensure operational effectiveness and efficiency of admission, concurrent and retrospective utilization management and medical claims functions to meet and ... At Houston Methodist, the Manager Case Mgmt Social Svcs position is responsible...and other areas according to department specifications. + Manages utilization management (UM) programs including Medical Claims… more
- Grifols Shared Services North America, Inc (Dallas, TX)
- …specified "Account List" of Health Systems designed to increase the adoption and utilization of the Grifols Bleeding Management product portfolio. The KAM's ... needs + Utilization of all available educational resources to develop knowledge about products and disease states while also utilizing these resources where… more
- Catholic Health Initiatives (College Station, TX)
- …2. Clinical Management a. Serves as a clinical resource for utilization management , compliance for the rules and regulations for government, non-government ... be REQUIRED in order to be considered for the Manager , Care Management postion.** + **Must be...Required License and Certification: Registered Nurse (RN) Required Minimum Knowledge , Skills, Abilities and Training: Strong verbal and written… more
- IQVIA (Austin, TX)
- **JOB** **OVERVIEW** The Manager of COA Project Management leads a team of Project Managers overseeing the translation and linguistic validation of Clinical ... vendor management , quality assurance, and operational process development + Knowledge of COA copyright practices and regulatory requirements in clinical research… more
- Bechtel Corporation (Sugar Land, TX)
- …decision-making skills with the ability to influence across functions. + Deep knowledge of construction equipment, fleet lifecycle management , and vendor ... a wholly owned Bechtel affiliate company, functions as the construction equipment asset manager of Bechtel Group and is actively engaged in projects across all of… more
- HCA Healthcare (Houston, TX)
- …other third party payers in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved by the ... improve positive outcomes for your patients as a Case Manager RN Registered Nurse. We want your knowledge...extended stays in accordance with criteria approved by the Utilization Management Committee and Medical Staff with… more