- HCA Healthcare (Houston, TX)
- …Summary and Qualifications** Under the general supervision of the Pre-Admit Manager , performs support services for the department, assigned clerical, secretarial, ... and related responsibilities, promoting communication between the Director, Manager , medical staff, hospital staff, and patients. Provides effective scheduling by… more
- HCA Healthcare (Dallas, TX)
- …staff committees as necessary. + Assists with staff performance evaluations. + Acts as manager in charge as assigned. + Provides review and guidance on physician ... participates in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement improvements… more
- CenterWell (Austin, TX)
- …Director of Physician Strategy at Utilization Management. The Medical Director conducts Utilization review of the care received by members in an assigned ... this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, review of all… more
- Highmark Health (Austin, TX)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Elevance Health (Houston, TX)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... appeal case reviews with attending physicians or other ordering providers to discuss review determinations. + Serves as a resource and consultant to other areas of… more
- NexTec Group (TX)
- …(Key Outcomes): + Complete assigned tasks independently and may collaborate with project manager to assign tasks to others according to team members' skill sets and ... within alignment of the Statement of Work, Business Process Review (BPR) documentation, and NexTec methodology. + Maintain at...and NexTec methodology. + Maintain at least 75 percent utilization on an average annual basis. + Maintain Acumatica… more
- Ryder System (Austin, TX)
- _Job Seekers can review the Job Applicant Privacy Policy by clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **SUMMARY** This ... education, audits, file reviews and performance appraisals of assigned staff. Assists Claim Manager with other staff as directed Assists in team leadership role when… more
- CenterWell (Corpus Christi, TX)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to improve… more
- Elevance Health (Grand Prairie, TX)
- …program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs. **How you will make an ... the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review , drug monographs, and formulary recommendations. + Develop strategies to… more
- Highmark Health (Austin, TX)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more
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