- Elevance Health (Houston, TX)
- ** Medical Management Nurse** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... service members in different states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse** is responsible for review of the most… more
- Highmark Health (Austin, TX)
- …URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care. + ... care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care… more
- Texas A&M University System (College Station, TX)
- Job Title Wage Agency Instructor - Medical Management of CBRNE Agency Texas A&M Engineering Extension Service Department Emergency Services Training Institute ... Temporary/Casual Staff (Fixed Term) Job Description Wage Agency Instructor - Medical Management of CBRNE $45.00 per hour 4 Positions Available Temporary/Casual… more
- Humana (Austin, TX)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- Health Care Service Corporation (Richardson, TX)
- …invest in your professional development. **Job Summary** This position leads all Medical Drug efforts within Enterprise Pharmacy. It sets strategic direction for ... Medical Drug reimbursement, oversees development of Medical Drug fee schedules (across Professional and Facilities), establishes governance and processes to… more
- Houston Methodist (Houston, TX)
- …to impact resource utilization and manage length of stay (eg, outliers, medical management practices, problematic patient/family dynamics). + Provides support ... Advisor position is responsible for teaching, consulting, and advising the case management department, clinical documentation specialists, medical staff and the… more
- CVS Health (Austin, TX)
- …- Ensures communication, both internally and externally, to enhance the effectiveness of medical management services (eg, health care providers, and health care ... it all with heart, each and every day. **Position Summary** The Care Management Associate (CMA) supports comprehensive coordination of medical services that… more
- Evolent (Austin, TX)
- …for utilization management while working in conjunction with the Senior Medical Director. May assist the Senior Medical Director in research ... Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management , you will be a key member of the...reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Humana (Austin, TX)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health ... providers, clinical group practice management . + Utilization management experience in a medical management.... + Utilization management experience in a medical management review organization, such as Medicare… more
- CenterWell (Austin, TX)
- …Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/ Integrated Delivery Systems, health ... group practice management . + Utilizationmanagement experience in a medical management review organization, such as Medicare Advantage,managedMedicaid, or… more