- Catholic Health Initiatives (Houston, TX)
- …coordinates scheduling of needed member appointments. + Reports to the Care Coordination Manager or Director for Quality and Utilization regarding member status ... local market network, this work includes: + Chronic Disease Management -Develops a plan of care based on a nursing...the Medical Social Worker, Licensed Social Worker or program manager based on the situation. + Concerns or complaints… more
- Elevance Health (Houston, TX)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... to Medical Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical program and/or independently… more
- LEGOLAND (Grapevine, TX)
- …**Operating Group: Gateway North America** **Division: Retail** **Reports to: Retail Manager ** **Job Level: Non- Manager ** **Exemption Status: Non-Exempt** **Job ... to the front-line team. The Retail Supervisor also Duty Manager shifts on the floor of the attraction overseeing...and promote teamwork. * Ensures proper coverage and staff utilization for assigned areas. * Coaches and manages Retail… more
- Elevance Health (Houston, TX)
- **Clinical Operations Medical Director** **Medical Oncology** **Carelon Medical Benefit Management ** **Virtual** : This role enables associates to work virtually ... proud member of the Elevance Health family of companies, Carelon Medical Benefits Management , formerly AIM Specialty Health, is a benefit- management leader in… more
- Elevance Health (Kerrville, TX)
- …required by law._ The **LTSS Service Coordinator-RN** is responsible for overall management of member's case within the scope of licensure; provides supervision and ... face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health,… more
- Ryder System (Austin, TX)
- …or if the Claim Manager is not available. Participates with Claim Manager in the selection and management of outside vendors for investigation, cost ... vendors retained for investigations, cost containment, expert witnesses, and litigation management to ensure claims are being handled properly according to the… more
- Veterans Affairs, Veterans Health Administration (Mcallen, TX)
- …(ICMHR-RANGE) Senior Social Worker is directly responsible to the Recovery Services Program Manager and ultimately to the Chief of Psychology and Associate Chief of ... The ICMHR Senior Social Worker: May be assigned direct clinical program management responsibilities for the ICMHR-RANGE services as indicated by ICMHR Program… more
- Highmark Health (Austin, TX)
- …terms through regular on-site audits. Apply an active role in network management , training, monitoring and enforcement of company policies and procedures while ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
- Molina Healthcare (TX)
- …reports submitted to the Eastern US Quality Improvement Collaborative (EQIC) and/or utilization management committees. + Participates as needed in joint ... Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM) or Certified… more
- Elevance Health (Houston, TX)
- …experience, which would provide an equivalent background. **Preferred Qualifications:** + Utilization management experience preferred. For candidates working in ... locations may be considered. CarelonRx delivers market-leading pharmacy benefit management and medication dispensing services to drive affordability and improve… more