- CommonSpirit Health (Houston, TX)
- …position and you must be licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case ... objectives for providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely with case and… more
- Wolters Kluwer (Coppell, TX)
- …Customer Success Specialist plays a high-impact role in managing strategy and product utilization across the PHT product portfolio. They serve as an advisor for our ... are established and strengthened, drive product adoption and ensure utilization goals are achieved to maximize value realization, implementation projects… more
- Centene Corporation (Austin, TX)
- …for the business unit. + Provides medical leadership of all for utilization management, cost containment, and medical quality improvement activities. + Performs ... medical review activities pertaining to utilization review, quality assurance, and medical review of complex, controversial, or experimental medical services,… more
- Molina Healthcare (Austin, TX)
- …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- Evolent (Austin, TX)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a ... meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient ... from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient...to obtain authorization for services as needed. * Conduct utilization reviews to monitor and optimize the use of… more
- Evolent (Austin, TX)
- …As a Cardiology, 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
- HCA Healthcare (Houston, TX)
- …other third-party payers in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved by the medical ... admissions and assigning extended stays in accordance with criteria approved by the Utilization Management Committee and Medical Staff with referral of all cases in… 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
- Evolent (Austin, TX)
- …match reviewer for Spine Surgery cases. 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