- HCA Healthcare (Austin, TX)
- …environment of quality and cost improvement and develops systems to review utilization of resources and objectively measure outcomes of care in the inpatient ... medical staff regarding clinical resource management, appropriate documents standards, utilization and quality issues, and quality improvement activities, in… more
- Molina Healthcare (Fort Worth, TX)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical ... Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for mental health… more
- Evolent (Austin, TX)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in ... to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization … more
- Devereux Advanced Behavioral Health (League City, TX)
- …This person will lead marketing initiatives and oversee the admissions and utilization management team for our residential treatment program for individuals with ... drive referrals. Additionally, the Director will supervise the admissions and utilization management department, ensuring a seamless and compassionate process for… more
- ConvaTec (Houston, TX)
- …goals. Identify, prioritize, pull-through, and close opportunities. + Ensure effective utilization of the products by all trained Health Care Professionals within ... proposition + Demonstrates clinical understanding of targeted surgical procedures + Optimize utilization of educational and KOL events (ie Examples are Trade Shows,… more
- Molina Healthcare (Austin, TX)
- …oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- Centene Corporation (Austin, TX)
- …issue resolution. Drive optimal performance in contract incentive performance, quality, and cost utilization . + Serve as primary contact for providers and act as a ... in the following areas: Risk/P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization , etc. + Completes special projects as assigned + Ability to travel… more
- Baylor Scott & White Health (Temple, TX)
- …patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and quality outcomes ... by effectively managing care and resources to reduce unnecessary utilization . **Location: Temple, TX - Baylor Scott & White Memorial Hospital** **Setting: Case… more
- Actalent (Austin, TX)
- …review findings, discharge plans, and actions in health management systems per utilization management policies + Work with providers to approve determinations or ... provide recommendations based on review findings + Educate providers on utilization processes to ensure high-quality care + Review transfer and discharge plans to… more
- Evolent (Austin, TX)
- …visualization, this role will collaborate cross-functionally to influence the effective utilization of data to deliver actionable insights, drive recommendations and ... of analytics & reporting experience in healthcare, including medical economics, cost/ utilization analysis, and membership trend reporting. + 5+ years of experience… more