• Utilization Management Nurse

    CenterWell (Austin, TX)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
    CenterWell (08/08/25)
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  • Utilization Management Nurse

    CenterWell (Austin, TX)
    …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
    CenterWell (08/02/25)
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  • Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Austin, TX)
    …should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote , Home Health Coding_ ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...also available). **BAYADA Perks:** + This role is **fully remote ,** candidates may be based anywhere in the US… more
    BAYADA Home Health Care (07/01/25)
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  • Clinical Coding and OASIS Review Manager

    BAYADA Home Health Care (Austin, TX)
    …with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote , Home Health Coding, Coder, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...they need. **BAYADA Perks:** + This is a fully remote , permanent salaried position. + Base Salary: **$74,000** /… more
    BAYADA Home Health Care (07/01/25)
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  • Remote Medical Director- Texas

    Centene Corporation (Austin, TX)
    …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
    Centene Corporation (08/02/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Austin, TX)
    utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a… more
    Evolent (07/30/25)
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  • Pharmacist (100% Remote , PBM, Entry-level)

    Actalent (Houston, TX)
    Pharmacist (100% Fully Remote ) Job Title: Pharmacist : Job Description: Your main role will be utilizing your clinical skills to complete utilization management ... of 6 Month(s) Work Site :This is a fully remote position. Work Environment: + These are fully ...opportunity after peak season to complete training for and review specialized cases (ex: oncology, hepatitis C, and other… more
    Actalent (08/09/25)
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  • Pharmacy Trade Relations Strategy Director…

    Prime Therapeutics (Austin, TX)
    …make. **Job Posting Title** Pharmacy Trade Relations Strategy Director - remote **Job Description** The Pharmaceutical Trade Relations Strategy Director facilitates ... key internal stakeholders including Clinical, Clinical Program Management, and Utilization Management to deliver financial opportunities to Prime's clients.… more
    Prime Therapeutics (07/22/25)
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  • Licensed/Certified Pharmacy Technician,…

    Molina Healthcare (Austin, TX)
    …Molina Healthcare is hiring for several Pharmacy Technicians. These roles are 100% Remote and require you be licensed either State or Nationally. These positions ... those involved in formulary management (such as, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services (such… more
    Molina Healthcare (06/25/25)
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  • Acumatica Senior Construction Consultant…

    NexTec Group (TX)
    …must be located in the United States or Canada. This is a remote role. Objectives (Key Outcomes): + Complete assigned tasks independently and may collaborate ... within alignment of the Statement of Work, Business Process Review (BPR) documentation, and NexTec methodology. + Maintain at...and NexTec methodology. + Maintain at least 75 percent utilization on an average annual basis. + Maintain Acumatica… more
    NexTec Group (05/25/25)
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