- Molina Healthcare (TX)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… 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 ... and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Wolters Kluwer (Dallas, TX)
- …efforts, prioritizing efforts and resources for assigned customer portfolio. + **Ongoing Utilization Management ** + Oversee and analyze customer utilization ... Engagement Manager plays a high-impact role in managing strategy and product utilization across the Wolters Kluwer Health's Clinical Decision Support & Provider… more
- Community Health Systems (Granbury, TX)
- …+ Refers cases not meeting criteria to the Physician Advisor or Utilization Management Committee and ensures appropriate follow-up. + Identifies avoidable ... Life and disability insurance and more **Job Summary** The Director, Care Management is responsible for overseeing the implementation, development, and management… more
- CVS Health (Austin, TX)
- …intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. The Care Management ... it all with heart, each and every day. **Position Summary** The Care Management Associate (CMA) supports comprehensive coordination of medical services that include… more
- Evolent (Austin, TX)
- …Stay for the culture. **What You'll Be Doing:** Job Description **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... meaningful impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use… more
- HCA Healthcare (Conroe, TX)
- … review/ management . + Consults with facility-level staff regarding delegated utilization management and disease management operations under managed ... ongoing in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues,… more
- Molina Healthcare (San Antonio, TX)
- …contributing to enterprise-wide strategies for integrated behavioral health programs, utilization management standardization, and cost-effective quality outcomes ... multi-state region. + Provides psychiatric leadership and clinical expertise for utilization management , case management , and integrated behavioral… more
- Devereux Advanced Behavioral Health (League City, TX)
- …This person will lead marketing initiatives and oversee the admissions and utilization management team for our residential treatment program for individuals ... drive referrals. Additionally, the Director will supervise the admissions and utilization management department, ensuring a seamless and compassionate process… 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