- Humana (Austin, TX)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... this knowledge in their daily work. The Medical Director's work includes computer based review of moderately complex to complex clinical scenarios, review of all… more
- Optiv (Austin, TX)
- …right staff assignments are made in right timeframes. + Maximize utilization . + Increase visibility of availability. + Assess skills/certifications against pipeline, ... the identification and assignment of services team members and subcontractors. + Review schedule data proactively to maintain high degree of timelines, accuracy, and… 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
- Providence (Plainview, TX)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... and Data Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records… more
- Capital One (Austin, TX)
- Sr. Manager, Technical Writer - Capital One Software ( Remote ) Ever since our first credit card customer in 1994, Capital One has recognized that technology and data ... complex information into user-friendly content that enables successful onboarding and utilization of Databolt by customers, partners and internal stakeholders. This… more
- Sedgwick (Plano, TX)
- …state and physician filings and decisions on appropriate treatments recommended by utilization review . + Maintains professional client relationships. + Performs ... Compensation | Jurisdiction: Multi State | TX/FL/OK/LA License preferred ( Remote /Hybrid) (Open) Are you looking for an opportunity to...of this radius will be considered for a fully remote arrangement. **PRIMARY PURPOSE OF THE ROLE:** We are… more
- SitusAMC (Austin, TX)
- …and address potential resource constraints or bottlenecks. + Report on resource utilization and manage capacity for the team. + **Project Planning and Coordination** ... (PPM) tool is a plus. + Experience working remotely and household setup conducive to remote work \#LI- AS1 #LI- Remote Note: This job description is not intended… more
- Prime Therapeutics (Austin, TX)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations, etc); compile ... **Job Posting Title** Senior Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Senior Compliance Analyst assists in the… more
- Prime Therapeutics (Austin, TX)
- …licensed functions (Pharmacy Benefit Management (PBM), Third Party Administrator, Utilization Review Organization, Business, State registrations etc.); compile ... with us. **Job Posting Title** Compliance Analyst (Regulatory Change Management) - Remote **Job Description** The Compliance Analyst assists in the implementation of… more
- Boehringer Ingelheim (Dallas, TX)
- …reflect Boehringer Ingelheim's high regard for our employees. This is a remote based position. **Duties & Responsibilities** + Develop, implement and manage brand ... to be implemented. + May be involved in the utilization of advanced analytics to simulate market dynamics in...marketing programs and material by working within the HPRC review process. + Assist in the development, management and… more