• Associate Director, Client Analytics

    Evolent (Austin, TX)
    …working seamlessly with diverse teams and stakeholders. + Deep understanding of prior authorization processes, reporting, and key performance indicators (eg, ... leadership is preferred. + Familiarity with value-based care models and utilization management frameworks is preferred. **Technical Requirements:** We require… more
    Evolent (05/01/25)
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  • Medical Director - National Medicare Team

    Humana (Austin, TX)
    …MHA, MPH + Prior experience participating in teams focusing on quality management or utilization management . **Additional Information** Reports to a Lead ... . + Prefer Medical Hematology/Oncology specialties + Prefer Medicaid experience + Utilization management experience in a medical management review… more
    Humana (05/07/25)
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  • Manager, Retirement Benefits

    Copeland (Austin, TX)
    …ensuring they meet employee needs and regulatory requirements.** **Vendor Relationship Management :** **Oversee and manage relationships with plan vendors, such as ... investment advisors and administrators, including sourcing, selection, and ongoing management of vendor partnerships.** **Retirement Investment Committee Support:** **Serve… more
    Copeland (03/21/25)
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  • Care Review Clinician, Inpatient Review (RN)

    Molina Healthcare (Dallas, TX)
    …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... financial responsibility for Molina Healthcare and its members. May also perform prior authorization reviews and/or related duties as needed. + Processes… more
    Molina Healthcare (04/12/25)
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  • Dock Supervisor

    ASM Global (Houston, TX)
    …north dock at NRG Stadium and NRG Center. + Ensuring all shipments received have prior authorization and verifying with the tenant any shipmentswithout prior ... adhering to OSHA Standards, applicable local codes and NFL's Best Practices. + Utilization of a variety of technological software, platforms, and devices. + Assist… more
    ASM Global (03/21/25)
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  • Senior Case Manager

    Cardinal Health (Austin, TX)
    …intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up ... guidance on the appeals process if needed. + Assist in obtaining insurance, prior authorization , and appeal requirements and outcomes. + Demonstrate expertise in… more
    Cardinal Health (04/29/25)
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  • Pharmacy Technician, Clinical/MTM

    Molina Healthcare (TX)
    …Services, pharmacies, and health plan providers in resolving member prescription claim, prior authorization , or pharmacy services access issues. * Articulates ... and state laws. Jobs in this family include those involved in formulary management (such as, reviewing drug/provider utilization patterns and pharmacy costs … more
    Molina Healthcare (05/03/25)
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  • Clinical Pharmacist Specialist BMT PRN

    HCA Healthcare (Dallas, TX)
    …participates in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement improvements ... services such as drug consults, nutrition support, pharmacokinetics, anticoagulant monitoring, pain management , IV to PO, renal dosing and other programs as defined… more
    HCA Healthcare (02/12/25)
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  • Senior Sourcing Manager - Meetings & Events

    American Express Global Business Travel (Austin, TX)
    …team members and suppliers of program status. + Review all supplier contracts prior to finalization, ensure both program specific and generic terms and conditions ... and the client, including attrition dates, cancellation policies, etc. Use appropriate authorization and addendum form to ensure consistency and accuracy. + Conduct… more
    American Express Global Business Travel (05/06/25)
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  • Clinical Pharmacist- REMOTE

    Prime Therapeutics (Austin, TX)
    …roles to develop and maintain project and benefit plan testing scenarios including utilization management , specialty and new client offerings + Interpret project ... systems to support benefit coverage decisions and contingent therapy, quantity limits, and prior authorization programs + Develop and maintain point of service… more
    Prime Therapeutics (04/25/25)
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