- Humana (Austin, TX)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... The UM Administration Coordinator 2 contributes to administration of utilization management. The UM Administration Coordinator 2 performs basic administrative,… more
- 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 (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
- 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 (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
- 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
- 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
- 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
- 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
- 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
Recent Jobs
-
Senior Manager Data Analytics
- The Walt Disney Company (New York, NY)
-
Senior Manager, UX Design - Core Ecommerce
- Walmart (San Bruno, CA)
-
Transportation Roadway Design Engineering Director
- Bowman (West Palm Beach, FL)
-
Pipe Loader Operator
- Jr. Davis Construction Company, Inc. (Kissimmee, FL)