- CVS Health (Austin, TX)
- …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in CT zones **Education**… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Utilization Management Registered Nurse 2 utilizes clinical nursing skills to support the ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …Healthcare Hospital (HBHH) currently has an opening for Full-time Lead Utilization Management Coordinator, Monday-Friday, 8a-4p. The Lead Utilization ... Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality...Review and will be responsible to provide quality case management services to all patients and their families, to… more
- CenterWell (Austin, TX)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- CenterWell (Austin, TX)
- …+ Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Orthopedic procedures + Compact License preferred + Previous experience in utilization management within Insurance industry + Previous Medicare… more
- Ascension Health (Georgetown, TX)
- …+ 1-2 years of Health Plan experience, preferred. + 1-2 years of Utilization Management experience, preferred. + High call phone volume experience, preferred. ... CST, Partially Remote, occasional weekends. + **Facility:** Ascension Care Management Insurance + **Location:** Seton Administrative Offices, 1345 Philomena, Austin,… more
- CVS Health (Austin, TX)
- …clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in ... and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and applies… more
- Houston Methodist (The Woodlands, TX)
- …eligibility for state, local, and federal programs + Progressive knowledge of utilization management , case management , performance improvement, and managed ... At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a...determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the plan… more
- Houston Methodist (Sugar Land, TX)
- …Provides education to physicians, nurses, and other health care providers on utilization management topics. + Initiates improvement of department scores for ... eligibility for state, local, and federal programs + Comprehensive knowledge of utilization management , case management , performance improvement, and managed… more
- Molina Healthcare (San Antonio, TX)
- **Knowledge/Skills/Abilities** + Perform research and analysis of complex healthcare utilization and performance date, claims data, pharmacy data, and lab data ... regarding utilization and cost containment information. + Evaluate, write, and...cost containment information. + Evaluate, write, and present healthcare utilization and cost containment reports and makes recommendations based… more