- HCA Healthcare (Houston, TX)
- …planning, implementation and overall evaluation of individual patient needs. Care coordination, utilization review and management , as well as discharge planning ... Coordinates and implements the discharge plan for patients with post -care needs (ie home health, DME, transfers to SNF,...care experience required. Minimum of two (2) years of utilization review/case management experience and minimum of… more
- CVS Health (Austin, TX)
- …review, and appeal request. This position is primarily responsible for Utilization Management , including prior authorization and precertification as well ... Independent Review Organization a Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience -Electronic medical… more
- Humana (Austin, TX)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Catholic Health Initiatives (Bryan, TX)
- …engaging other relevant health team members, the patient and/or patient representative and post - acute care providers in accordance with the patient's clinical or ... established evidence based guidelines/criteria. 5. Collaborates with the healthcare team and post - acute service providers to ensure timely and smooth transitions… more
- Baylor Scott & White Health (Dallas, TX)
- …external independent providers - including physicians, hospitals, allied health professionals, post - acute and ancillary providers - as well as administrators, ... types, such as employed, independent, and hospital-based practices as well as post - acute providers. - Oversees the successful formulation, development, and… more
- Apex Health Solutions (Houston, TX)
- …and cooperates with internal and external stakeholders. Collaborates effectively with Utilization Management , Quality Management , Pharmacy, Provider ... Summary Responsible for providing case management services and support to improve health outcomes...members, as well as pcp, specialists, clinic, hospital, and post - acute partners, along with community resources, to… more
- Prime Healthcare (Harlingen, TX)
- …manage care transitions. RN Case Managers also conduct discharge planning, utilization review, and helping patients navigate insurance and healthcare systems. ... plans, including referrals to rehab, home health, or long-term care facilities + Utilization Review: m onitor the use of hospital resources and services to ensure… more
- HCA Healthcare (Austin, TX)
- …Registered Nurse in transplant services + Minimum 3 years' experience in Case Management / Utilization Education + Graduate of an accredited school of nursing, BSN ... emergencies, and others meeting admission criteria. Common diagnoses seen include acute leukemia, non Hodgkin's lymphoma and multiple myeloma. You will be… more
- ChenMed (Houston, TX)
- …role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education and identify post -SNF needs. + ... of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed standards for… more
- BD (Becton, Dickinson and Company) (Houston, TX)
- …required. **Preferred Qualifications:** + 2+ years of relevant Sales/Account Management /Customer Success experience preferred. Acute Hospital experience ... + Alignment with strategic sales teams on key IDNs + Contract compliance management + Required to maintain an up-to-date business plan detailing strategy to maintain… more