- Elevance Health (Kerrville, TX)
- …The **LTSS Service Coordinator-RN** is responsible for overall management of member's case within the scope of licensure; provides supervision and direction to ... non-RN clinicians participating in the member's case in accordance with applicable state law and contract;...co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits. + Obtains a thorough and… more
- Medtronic (Houston, TX)
- …the Life** The Surgical Onsite Specialist (SOS) is responsible for providing case support and customer support, training and education, and solution implementation ... Surgical Centers of Therapy (COTs). This role ensures seamless product utilization by assisting with on-site procedures, addressing customer inquiries, performing… more
- Molina Healthcare (TX)
- …must be active and unrestricted in state of practice. * Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), Certified Professional ... services professionals, in some or all of the following functions: utilization management, care management, care transitions, behavioral health, long-term services… more
- Molina Healthcare (Austin, TX)
- …Certified Clinical Coder (CCC), Certified Medical Audit Specialist (CMAS), Certified Case Manager (CCM), Certified Professional Healthcare Management (CPHM), ... medical officer on denial decisions. * Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) issues. * Identifies… more
- Catholic Health Initiatives (The Woodlands, TX)
- …role with the interdisciplinary team to achieve optimal outcomes through the tools of case management. The case manager will perform a wide variety ... of patients across the continuum of illness; promote effective utilization ; monitor health care resources; and assume a leadership...provision of services necessary to meet those needs. The case manager must be knowledgeable in community… more
- Catholic Health Initiatives (Lake Jackson, TX)
- …role with the interdisciplinary team to achieve optimal outcomes through the tools of case management. The case manager will perform a wide variety ... of patients across the continuum of illness; promote effective utilization ; monitor health care resources; and assume a leadership...provision of services necessary to meet those needs. The case manager must be knowledgeable in community… more
- Lumen (Austin, TX)
- …and track improvements in technologies and processes. + Analyze system utilization statistics to identify performance bottlenecks and recommend enhancements for ... and vendor-specific appliances. + Proven ability to analyze system throughput, utilization , and capacity to inform infrastructure decisions. + Self-motivated with a… more
- CenterWell (Austin, TX)
- …teams focusing on transitions of care, quality management,utilizationmanagement, case management, discharge planning and/or home health or post-acute ... of business metrics. + Experience working with Casemanagersor Caremanagerson complex case management, including familiarity with social determinants of health. + The… more
- Elevance Health (Houston, TX)
- …clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss ... Director Associates. + Works independently with oversight from immediate manager . + May be responsible for an entire clinical...state or territory of the United States when conducting utilization review or an appeals consideration and cannot be… more
- ChenMed (Houston, TX)
- …a plan of care, providing health education, specialty referrals and case management referrals, providing follow-up care and applying clear, in-depth documentation ... requests for external cardiology referrals and participates in delegated utilization authorizations; determines level of urgency of follow-up, referral/consultation… more
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