• Behavioral Health Care Manager I

    Elevance Health (Grand Prairie, TX)
    …Manager I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder ... inpatient and outpatient benefits through telephonic and written processes. Also provides telephonic support for crisis intervention, assessment and short-term problem resolution and referral to appropriate provider(s). **Location:** Virtual: This role enables… more
    Elevance Health (10/09/25)
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  • Medical Director

    Health Care Service Corporation (Richardson, TX)
    …experience + Hematology and Oncology experience + Peer to peer experience + Utilization Management /review experience **This is a Telecommute (Remote) role: Must ... reside withing 250 miles of the office or anywhere within the posted state.** **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service… more
    Health Care Service Corporation (10/08/25)
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  • Provider Appeals & Grievances Specialist (remote)

    Cognizant (Austin, TX)
    …of member benefits, eligibility, provider contracts, billing and coding, Utilization Management and state Medicaid policies. **Qualifications/Skills Needed:** ... 1-2 years of Appeals and Grievance 1 yr. medical claims processing experience (Must be with a healthcare plan, not on behalf of provider or provider's office) Medicaid insurance customer service or claims processing Medicaid/Medicare Insurance Customer Service… more
    Cognizant (10/07/25)
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  • Vice President, Cardiology

    Evolent (Austin, TX)
    …a key clinical executive responsible for leading cardiology- and vascular-related utilization management , quality improvement, and clinical operations across ... Evolent's value-based care platform. This role ensures consistent, high-quality adjudication of cardiology decisions and serves as a strategic liaison between clinical teams and clients. The VP will serve as a key strategic thought-partner in shaping Evolent's… more
    Evolent (10/07/25)
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  • Medical Director - Medicare Grievances and Appeals…

    Humana (Austin, TX)
    …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health insurance ... organizations, hospitals and other healthcare providers, patient interaction, etc. + Internal Medicine, Family Practice, Geriatrics, Hospitalist, Anesthesiology, Physical Medicine and Rehabilitation, Emergency Medicine, and General Surgery clinical specialists… more
    Humana (10/02/25)
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  • Medical Authorization Splst

    Methodist Health System (Dallas, TX)
    …works with physicians, clinic support staff, case managers, nurses, insurance utilization management staff, and patients to initiate pre-authorization and ... resolve issues that arise during the prior authorizations process. Supports and promotes the vision, mission, and strategic plans of Methodist Health System Your Job Requirements: * High School Graduate or equivalent. Some college preferred * 1 year of prior… more
    Methodist Health System (09/20/25)
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  • Corporate Medical Director - Medicare Grievances…

    Humana (Austin, TX)
    …focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience + Working with health insurance ... organizations, hospitals and other healthcare providers, patient interaction, etc. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office… more
    Humana (09/05/25)
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  • Telephonic Nurse Case Manager II

    Elevance Health (Houston, TX)
    …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with...assessments to identify individual needs and a specific care management plan to address objectives and goals as identified… more
    Elevance Health (10/10/25)
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  • Utilities Control System Technician

    Texas A&M University System (College Station, TX)
    …operation control systems + Responsible for providing centralized coordination for the utilization of energy management control systems in campus facilities + ... operation control systems + Responsible for providing centralized coordination for the utilization of energy management control systems in campus facilities +… more
    Texas A&M University System (09/30/25)
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  • Supervisor, Building Automation

    Texas A&M University System (College Station, TX)
    …Automation Systems, under general direction, provides centralized coordination for the utilization of energy management control systems in campus facilities. ... years of related experience with primary responsibility for facility operations management and direct responsibility for building automation and energy management… more
    Texas A&M University System (09/24/25)
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