- Health Care Service Corporation (Richardson, TX)
- …reviews in accordance with the medical contract and regulations, medical criteria, utilization review , and quality of care. **JOB REQUIREMENTS** **:** + ... are not required to obtain multi-state licenses. **PREFERRED JOB REQUIREMENTS** **:** + Utilization review or utilization management experience + Insurance… more
- Olsson (Austin, TX)
- BMS Engineering Leader - Data Center Arizona - Remote ; Arkansas - Remote ; Florida - Remote ; Georgia - Remote ; Idaho - Remote ; Illinois - Remote ; ... Remote ; Iowa - Remote ; Kansas - Remote ; Kentucky - Remote ; Louisiana - ...Monitor and enhance the group's project performance and employee utilization and workload, identifying potential areas of improvement and… more
- Kemper (Dallas, TX)
- Location(s) Remote -AL, Remote -CT, Remote -FL, Remote -GA, Remote -IL, Remote -IN, Remote -MI, Remote -NC, Remote -OH, Remote -PA, ... complex technical problems and issues with assigned applications and work processes. + Review and recommend test plans for impacted areas and end to end test… 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
- Texas A&M University System (College Station, TX)
- …accounts. Monitors and reports on CMTS budget activity, including service-block utilization . Prepares monthly and annual financial reports. Provides input to ... maintains CMTS operational reports, including active project reports, service-block utilization , and workload summaries; may create or update reporting dashboards… more
- Oracle (Austin, TX)
- …procedures, contractual budgets, providing expert-level insight on the development, utilization , and revision of contractual agreements. + Maintains customer ... to key leaders. Technical Delivery Management: + Leading the review of and advises customers on optimal use and...service to customers and optimize overall product and service utilization to achieve ROI goals, influencing roadmaps and customer… more
- MD Anderson Cancer Center (Houston, TX)
- …for improvement. * Assist with appropriate patient assignment following referral review and ensure timely redirection when needed. * Escalate provider or ... distribution to ensure operational efficiency. * Track attendance, manage overtime utilization , and maintain financial accountability within the unit. * Use data… more
- CVS Health (Austin, TX)
- …more compassionate. And we do it all with heart, each and every day. Fully remote Standard business hours. 1 late day until 7pm your local time. No holidays. ... and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes. Assessment of… more
- CVS Health (Austin, TX)
- …is with Aetna's National Medical Excellence (NME) team and is a fully remote position. Candidates from any state are welcome to apply, however, preference is ... is a blended role doing both Case Management and Utilization Management. The RN Case Manager is responsible for...- Through the use of clinical tools and information/data review , conducts an evaluation of member's needs and benefit… more
- Ross Stores, Inc. (Dallas, TX)
- …Operations, MPT, etc\.\) and analytics\. * Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to ... the company and address new types of theft and fraud\. * Maximize utilization of all available merchandise protection tools and resources \(including EAS, domes,… more