- Centene Corporation (Austin, TX)
- …appeals, and occasional peer-to-peer consultations, as well as participating in Utilization Management clinical rounds.** **We're seeking candidates who:** + ... an active Oklahoma Psychologist license** + **Are familiar with Medicaid guidelines, prior authorization , and telehealth practices** + **Thrive in a… more
- 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
- Actalent (Houston, TX)
- …Utilization Review (DUR) for Medicaid and Medicare. + Review and assess prior authorization requests. + Provide clinical support across internal departments ... of residence. + Experience in managed care, clinical program development, or prior authorization review preferred. + Strong communication and analytical skills.… more
- 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
- Molina Healthcare (Houston, 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 (San Antonio, TX)
- …physician leadership and expertise in the performance of prior authorization , inpatient concurrent review, discharge planning, case management and ... years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review,… more
- Prime Therapeutics (Austin, TX)
- …and timely fashion. + Demonstrates the value of pharmacy solutions (unit cost, utilization management & patient care enhancement). + Identifies opportunities for ... functions, DUR committees and responsibilities. + Supports elevated customer service and prior authorization inquiries specific to assigned accounts. + Manages… more
- CVS Health (Austin, TX)
- …responsible for predetermination reviews and reviews of claim determinations. This includes Prior Authorization / Pre Certification / Concurrent Reviews / Peer ... of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum...the continuum of care. You will support the Medical Management staff ensuring timely and consistent responses to members… more
- HCA Healthcare (Jourdanton, TX)
- …applicable). Minimum License, Certificates, or Registrations Required: ONE of the following prior to the first day of employment: A. Current Registered Pharmacist ... Board of Pharmacy B. Licensed pharmacist in another state: Provide proof of the Authorization to Test (ATT) from the Texas State Board of Pharmacy Essential Job… more
- Bridgestone Americas (Mission, TX)
- …equipment, service associates and service instruction to increase capacity utilization through efficient/effective processing of tire and service demand. ... and special meetings as required by store or area management . + As needed, helps to unload merchandise shipments,...store as needed + Spray tires with black paint prior to putting on display to cover manufacturing lines… more