- CVS Health (Austin, TX)
- …+ Job Description Primary Job Duties & Responsibilities Drives effective utilization management practices by ensuring appropriate and cost-effective allocation ... efficient use of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of… more
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** This Utilization Management (UM) Nurse Consultant role is 100% remote and the candidate can ... **Rotational late shift 9:30-6CST.** **No travel is required.** As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate,… more
- CVS Health (Austin, TX)
- …more compassionate. And we do it all with heart, each and every day. Utilization Management - Infertility Precertification unit **Position Summary** This is a ... of experience with Microsoft Office applications (Outlook, Teams, Excel) + Utilization Management is a 24/7 operation and work schedules will include holidays… more
- 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 ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central time zones… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and… more
- Molina Healthcare (Austin, TX)
- Molina Healthcare is hiring for a remote Pharmacist in our Utilization Management department. This role is 100% remote. The Pharmacist, UM will provide support ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assist leadership team in understanding quality and cost-control issues… more
- Elevance Health (Grand Prairie, TX)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person ... employment, unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls,… more
- Cognizant (Austin, TX)
- …+ Educational background - Registered Nurse (RN) + 2-3 years combined clinical and/or utilization management experience with managed health care plan + 3 years' ... in health care revenue cycle or clinic operations + Experience in utilization management to include Clinical Appeals and Grievances, precertification, initial… 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
- Prime Healthcare (Dallas, TX)
- …Us! (https://careers-primehealthcare.icims.com/jobs/239868/multi-site-pi-director utilization - management /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... decrease errors, increase efficiency and ultimately improve care and appropriate utilization of informatics to communicate, manage knowledge with clinical expertise… more