- Molina Healthcare (San Antonio, TX)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, disease management ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and...resource management . + Develops and implements a Utilization Management program and action plan, which… more
- Highmark Health (Austin, TX)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... participates as the physician member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Evolent (Austin, TX)
- …Doing:** 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 ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Deloitte (Dallas, TX)
- …to collaborate with clinicians, physicians, NP/PAs, ancillary departments, Quality, Case Management , Finance, Revenue Cycle, and Coders + Other skills include the ... to ensure regulatory compliance + Apply knowledge of medical terminology, disease conditions and procedures to evaluate clinical documents + Monitor diagnoses,… more
- CVS Health (Austin, TX)
- …Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible ... interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing… more
- UTMB Health (Angleton, TX)
- …nurses, and the nursing aspects for specialty quality standards (eg critical care, disease management , etc.). + Demonstrates transparency with the clinical staff ... Delivery - Angleton **Angleton, Texas, United States** **Hot** Nursing & Care Management UTMB Health Requisition # 2506427 **Minimum Qualifications:** RN with a… more
- UTMB Health (Galveston, TX)
- …+ Expand pharmacist-led services in areas such as transitions of care, chronic disease management , oncology, infusion therapy, and ambulatory care clinics. + ... the delivery of high-quality, evidence-based, and cost-effective medication therapy management , aligning with organizational goals for clinical excellence, patient… more
- HCA Healthcare (Austin, TX)
- …Management . Clinical experience with adults. + Preferred experience: risk management , workers compensation, healthcare administration , and an understanding of ... for staff performing duties in multiple physical locations. Works with clinical, management , and other support personnel to coordinate both on and off-site physical… more
- UTMB Health (Angleton, TX)
- …and the nursing aspects for specialty quality standards (eg critical care, disease management , etc.). + Collaborates with ACNOs to promote patient ... the quality and efficiency of patient care services provided, the management of allocated resources, and effective planning, evaluation and administrative problem… more
- HCA Healthcare (Austin, TX)
- …Summary and Qualifications** The Manager of Cardiovascular Services provides leadership and management to all personnel within an assigned units. The Manager of ... clinical functions and operations of the assigned area or units to include quality management , personnel management , fiscal management , management and… more