- Humana (Austin, TX)
- …Medicare and Medicaid LOB - Medicare Clinical Criteria Review (MCCR), Utilization Management Committee (UMC), Medical Coverage Policy Adoption (MCPA) + Perform ... Qualifications** + Master's degree in health-or business-related field + Utilization management experience (Commercial and/or Medicare) + Proven successful… more
- AbbVie (Austin, TX)
- …Company products, with high accountability for achieving the territory sales and utilization quotas and objectives. The IPDM will also provide technical product and ... calls daily, as well as daily response to emails. Achieving sales and utilization quota results in the assigned territory. Responsible for educating and supporting… more
- CVS Health (Austin, TX)
- …internal teams. Conduct system health checks, capacity planning, and resource utilization analysis, adhering to industry standards and security protocols. Ensure all ... reliability. Conduct system health checks, capacity planning, and resource utilization analysis, ensuring compliance with industry standards and security protocols.… more
- Molina Healthcare (Fort Worth, TX)
- …role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate with ... 3-5 years clinical practice with managed care, hospital nursing, utilization and/or care management experience. **Preferred License, Certification, Association**… more
- CVS Health (Austin, TX)
- …AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support ... transferring patients to lower levels of care. + 1+ years' experience in Utilization Review. + CCM and/or other URAC recognized accreditation preferred. + 1+ years'… more
- Molina Healthcare (TX)
- …clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active, unrestricted ... Utilization Management Certification (CPHM). **MULTI STATE / COMPACT LICENSURE required.** **Individual state licensures which are not part of the compact states are… more
- Houston Methodist (The Woodlands, TX)
- …the case management and social work department to facilitate efficient utilization of resources and discharge planning including referrals management, communication ... assists with concurrent insurance denials and appeals process, transmission of utilization reviews to insurance companies, coordination of peer discussions as… more
- The City of Houston (Houston, TX)
- …EXPERIENCE REQUIREMENTS Two years of experience in traffic and street utilization investigations are required. An Associate's degree in Drafting, Construction ... verifiable experience 04 How many years of experience do you have in traffic and street utilization investigations? + No Experience + 2 - 3 years of experience + 3 -… more
- Black & Veatch (Cleveland, TX)
- …project management team, and other stakeholders to optimize equipment utilization , cost management, forecasting, and planned maintenance. Travel is required ... routine equipment plan review meetings.*Distribute, schedule, and plan weekly utilization reviews of project equipment.*Ensure weekly, monthly, and annual equipment… more
- Houston Methodist (The Woodlands, TX)
- …in accordance with staffing grid. + Provides input into unit resource utilization including unit capital and operational budget needs. Oversees shift by shift ... resource utilization through the allocation of staff, supplies and contributions to the patient throughput. **GROWTH/INNOVATION ESSENTIAL FUNCTIONS** + Fosters… more