- Molina Healthcare (Fort Worth, TX)
- **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services /Management staff work to ensure that Molina members have access to all medically necessary prescription ... drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such as, therapeutic drug monitoring, drug regimen review, patient… more
- CenterWell (Austin, TX)
- …of senior-focused primary care, one of the largest providers of home health services , and fourth largest pharmacy benefit manager , CenterWell is focused on ... provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members,...non compact licensure + 3 - 5 years of Medical Surgery, Heart, Lung or Critical Care Nursing experience… more
- Elevance Health (Grand Prairie, TX)
- …by law._ This role's primary focus is ABA utilization management The ** Manager Behavioral Health Services ** is responsible for Behavioral Health Utilization ... Management (BH UM ). **How you will make an impact:** + Serves...make an impact:** + Serves as a resource for medical management programs. + Identifies and recommends revisions to… more
- Elevance Health (Houston, TX)
- …granted as required by law. **Work Shift:** 8AM -5PM CST **Behavioral Health Care Manager l** The **Behavioral Health Care Manager I** is responsible for ... necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as… more
- Highmark Health (Austin, TX)
- …management strategies including: review of appropriateness of health care services , application of criteria to ensure appropriate resource utilization, ... of quality issues. Monitors and analyzes the delivery of health care services ; educates providers and members on a proactive basis; and analyzes qualitative… more
- MTC (Raymondville, TX)
- …a healthy, productive life.** **What you'll do:** You'll be responsible for providing medical services related to diagnosis and treatment of detainee patients ... program by providing the required level of efficiency and approved appropriate medical services . 15. Comply with requirements of applicable regulations, laws,… more
- MTC (Anson, TX)
- …and clinically to the MTC Corporate Medical Director. Responsible for providing medical services related to diagnosis and treatment of detainee patients and ... program by providing the required level of efficiency and approved appropriate medical services . + Comply with requirements of applicable regulations, laws,… more
- Molina Healthcare (TX)
- …department inventories within the key performance requirements. * Coordinates with Customer/Member services , Provider Services , Sales, Enrollment, UM , Case ... regarding A&G operations and dependencies. * Responsible for the A&G department service levels to include internal and external reporting requirements. * Reviews and… more