- Health Care Service Corporation (Richardson, TX)
- …with topics that include Claims and Payment Integrity, Member Engagement, Utilization Management , Document Intelligence, Risk Stratification, and the AI ... Solutions team at HCSC. The role reports to the Senior Director of Product Management for AI Solutions. There are many different domains (or thematic units) within… more
- Humana (Austin, TX)
- …to deliver exceptional, person-centered support to members through role-specific care and utilization management activities. This is an opportunity to foster ... and optimize learning processes, including program marketing, registration, resource management , and follow-up communications. + Plan for departmental growth and… more
- UTMB Health (Galveston, TX)
- …and accurate information to payers. The role integrates and coordinates utilization management , care coordination and discharge planning functions. **Equal ... TDCJ Holdover **Galveston, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2505361 **Minimum Requirements:** RN with Bachelor's… more
- Molina Healthcare (TX)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... software program(s) proficiency. Preferred Qualifications * Certified Professional in Healthcare Management (CPHM). * Recent hospital experience in an intensive care… more
- Elevance Health (Grand Prairie, TX)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... complex psychiatric/substance abuse cases required. + Prior managed care experience required. **Preferred Skills, Capabilities, and Experiences:** + BCBA and LBA is STRONGLY PREFERRED For candidates working in person or virtually in the below location(s), the… more
- Wolters Kluwer (Coppell, TX)
- …to retain and grow existing commercial customer base + Review account utilization management reporting and provide recommendations + Conduct regular account ... The Sr. Strategic Account & Relationship Management Executive will be responsible for managing and growing existing Commercial Customer relationships in a defined,… more
- UTMB Health (Galveston, TX)
- …system data entry of information such as referral requests, drug utilization management information, prepacking information, drug purchasing information, or ... medications + Participates in the operations of medication therapy management + Initiates medication reconciliation + Assists with screening, documentation,… more
- UTMB Health (Huntsville, TX)
- …system data entry of information such as referral requests, drug utilization management information, prepacking information, drug purchasing information, or ... medications + Participates in the operations of medication therapy management + Initiates medication reconciliation + Assists with screening, documentation,… more
- Houston Methodist (Houston, TX)
- …in a hospital setting + Two years of experience in Hospital Quality Improvement, Case Management or Utilization Management role preferred + Two years of ... leadership experience preferred **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure - Must obtain permanent Texas license within 60 days (if establishing Texas residency) **LICENSES AND CERTIFICATIONS… more
- UTMB Health (Webster, TX)
- …system data entry of information such as referral requests, drug utilization management information, prepacking information, drug purchasing information, or ... medications + Participates in the operations of medication therapy management + Initiates medication reconciliation + Assists with screening, documentation,… more