- CVS Health (Austin, TX)
- …* Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. **Education** * Active and current ... effective use of health care resources. **This is a remote based (work from home) role.** In this role...issues * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases… more
- 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
- Molina Healthcare (Fort Worth, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... be licensed for the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer candidates with a… more
- CVS Health (Arlington, TX)
- …Field Experience. + Bilingual. + Crisis intervention skills preferred. + Managed care/ utilization review experience preferred. + Case management and discharge ... every day. **Clinical Case Manager Behavioral Health** **Position Summary** This is a remote role, requiring 75% travel to meet in-person with members around our… more
- Humana (Austin, TX)
- …involvement in day-to-day UM activities and discussions with UM leaders. 20% 2. Review and monitor Contract Change Orders and evaluate impact on Utilization ... related medical field + Minimum of 5 years experience utilizing medical necessity review criteria (EG MCG, InterQual) + **Our Department of Defense Contract requires… more
- Humana (Austin, TX)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Begins to influence department's… more
- Arrow Electronics (Plano, TX)
- …design, product and proof of concept demonstrations, solution consultation, architecture review , and enablement of Arrow partners. The SED possesses a background ... Solutions Lab as a key differentiator for Arrow. Drive utilization through technology demonstrations, POCs, and innovation tied to...to assist in closing a deal. **Work Arrangement:** Fully Remote : Must be able to travel to an Arrow… more
- MD Anderson Cancer Center (Houston, TX)
- …or treatment team concerning home care, potential problems, emotional concerns or utilization review status. Participates in regularly scheduled team conferences ... loop records, takes phone calls from device patients, manages remote checks, and collaborates with MDs, RNs, and devices...abreast of developments in the field of nursing or utilization review by attending seminars and workshops,… more
- Humana (Austin, TX)
- …health insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization, ... provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present educational… more
- TruePoint Communications (TX)
- …company and four-time Top 100 PR agency in the US We've had both remote and hybrid office environments before it was popular. Some of our favorite perks ... Manage staffing to maintain optimal coverage, skill sets, and utilization across accounts + Take ownership of account team...team. All marcom employees roll up to Director + Review , approve, and sign off on all marcom clients'… more