- MTC (Raymondville, TX)
- …4. Refer patients for specialty consultations and treatment through the utilization manager process. 5. Utilize established corporate, facility and corrections ... all potential catastrophic illnesses. 9. Implement basic cost containment and utilization management for patient care and facility operations. 10. Comply with… more
- MTC (Anson, TX)
- …+ Refer patients for specialty consultations and treatment through the utilization manager process. + Utilize established corporate, facility and corrections ... Monitor all potential catastrophic illnesses. + Implement basic cost containment and utilization management for patient care and facility operations. + Comply with… more
- Centene Corporation (Austin, TX)
- …of Certifying Board Service (Internal and Family Medicine, preferred) + Utilization Management experience and knowledge of quality accreditation standards. + ... for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs… more
- Centene Corporation (Austin, TX)
- …for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs ... medical review activities pertaining to utilization review, quality assurance, and medical review of complex,...the Chief Medical Director in the functioning of the physician committees including committee structure, processes, and membership. +… more
- Texas Health Resources (Plano, TX)
- …provide administrative oversight and assistance with hospital's medical staff, physician recruitment, hospital operations and clinical programs in collaboration with ... in RCAs and reviews of clinical cases with quality concerns. d. Support Utilization efficient and effective throughput in the on-going monitoring of physician … more
- Houston Methodist (Houston, TX)
- …strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for ... initiatives aimed at optimizing patient progression of care, aligning utilization review practices, enhancing discharge planning processes, and strengthening… more
- ChenMed (Houston, TX)
- …patient/family conferences to review treatment goals and optimize resource utilization ; provides family education and identifies post-hospital needs. + Serves ... reports adverse occurrences, and performs staff education related to resource utilization , discharge planning and psychosocial aspects of healthcare delivery. +… more
- Molina Healthcare (San Antonio, TX)
- …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- Houston Methodist (Houston, TX)
- …clinical and management outcomes, including high degree of patient and physician satisfaction. Implements change, demonstrating the ability to motivate employees and ... the department. + Participates in leadership meetings and committees of the Physician Organization or Hospital. Leads efforts to create an environment of… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer, Interventional Pain Management, you will be a key member of the ... utilization management team. We can offer you a meaningful...and management staff, other Physicians, and staff whenever a physician `s input is needed or required. Aids and acts… more