- Molina Healthcare (Austin, TX)
- …requestors to ensure appropriate creation of reports and analyses. Uses peer-to-peer review process and end-user consultation to reduce errors and rework + Practice ... + Demonstrate Healthcare experience in Quantifying, Measuring and Analyzing Financial and Utilization Metrics of Healthcare + Advanced knowledge of SQL + Proficient… more
- Healthfirst (TX)
- …in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management/case management. + Demonstrated ... This position is 100% Remote . We are hiring for the following schedules...understanding of Utilization Review Guidelines (NYS ART 44 and 49 PHL), InterQual,… 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
- 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
- Fujifilm (Austin, TX)
- …identifying activities, sponsorships, and equipment needed to ensure success. + Review and consideration of event participation levels and requirements, involving ... key stakeholders as needed, and share with review committee for consideration. + Timely, proactive sharing and...data monitoring, analysis, summary, and report generation for sales utilization of Showpad materials and platform, including areas of… 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
- AECOM (Dallas, TX)
- …to I&G Director for annual budgets and business planning, staff utilization , department resource needs (hardware/software needs, strategic investments) and other ... future resource and staff needs to optimize the department staff utilization , including incorporation of value Engineering Centers in project staff planning… 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
- 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
- Humana (Austin, TX)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post… more
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