- 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
- Guidehouse (Lewisville, TX)
- …with insurance portals + PC skills in a Windows environment. + Knowledge and utilization of desktop applications to include Word and Excel. + Ability to initiate and ... follow through on projects and work independently with minimal supervision. **What We Offer** **:** Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to… 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
- Evolent (Austin, TX)
- …requested basis, reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with Physician Business ... and management staff as well as health plan members and staff whenever a physician `s input is needed or required. Responsible for clinical audits for quality and… more
- Molina Healthcare (Austin, 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
- Catholic Health Initiatives (Houston, TX)
- …market accountabilities as the MCMO include patient safety, patient experience, physician engagement, physician recruitment, and medical staff affairs. A ... high‐value, safe patient care through oversight of all aspects of physician performance, quality, and clinical integration. Specifically responsible for providing… more
- ConvaTec (Fort Worth, TX)
- …goals. Identify, prioritize, pull-through, and close opportunities. + Ensure effective utilization of the products by all trained Health Care Professionals within ... and build relationships across multiple care settings (ie OR, Nursing Units, Physician Offices, Care Coordinators, Cath Lab, L&D, etc.), and use information gathered… more
- Houston Methodist (Houston, TX)
- …units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and interprofessional ... health care team to ensure resource utilization is appropriate to the patient's clinical needs and...close communication to the unit department regarding patient and physician requests to ensure smooth transition of patients in… more
- Houston Methodist (Cypress, TX)
- …safety. The CQO position collaborates with the System CQO and other system physician leadership in quality and patient safety to support the development of the ... + Works with the System CQO and entity CQOs of HM including the Physician Organization to integrate quality programs throughout the HM system and throughout the… more
- Houston Methodist (Tomball, TX)
- …primary care, while practicing medicine under the supervision of a licensed physician . This position will provide diagnostic, therapeutic and preventative care to ... perform independently under the indirect supervision of a license physician or as part of a treatment team. The...and skills. + Contributes to department plans for resource utilization and capital needs to meet department financial target.… more