- Highmark Health (Austin, TX)
- …of various projects and data analysis related to Medical Policy and Utilization Management . **ESSENTIAL RESPONSIBILITIES** + Perform management ... experience in a supervisory capacity or role **Preferred** + Experience in Utilization Management and/or Medical PolicyExperience working with claims data… more
- ChenMed (Houston, TX)
- …in conjunction with the transitional care team; hospital, SNF, post-acute, delegated utilization management and home-based services for the market. + Performs ... plan of care, providing health education, specialty referrals and case management referrals, providing follow-up care and applying clear, in-depth documentation… more
- Molina Healthcare (Dallas, TX)
- …Tableau and data management . * Advanced understanding health care operations ( utilization management , disease management , HEDIS quality measures, claims ... tracking tools and identify opportunities to improve performance and data management , and support, guide and influence decision-making related to clinical programs,… more
- Health Care Service Corporation (Richardson, TX)
- …clinical staff involved in a variety of behavioral health clinical operations such as Utilization Management , Case Management and/or Disease Management . ... Responsible for hiring, training, performance reviews, pay administration, change management and ensuring staff meet/exceeds goals and initiatives. Implement… more
- Baylor Scott & White Health (Temple, TX)
- …Associate's degree in nursing. Specialty Certification strongly encouraged. Knowledge of care management , resource and utilization management . Skilled in ... quality outcomes by effectively managing care and resources to reduce unnecessary utilization . **Location: Temple, TX -** **2401 South 31st Street, Temple, 76508**… more
- MTC (Anson, TX)
- …+ Monitor all potential catastrophic illnesses. + Implement basic cost containment and utilization management for patient care and facility operations. + Comply ... + **Paid Time Off (PTO)** + **Paid Holidays** **Looking to impact lives? At Management & Training Corporation (MTC) Medical, our purpose is to help those in need.… more
- Humana (Austin, TX)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- MTC (Raymondville, TX)
- …Monitor all potential catastrophic illnesses. 9. Implement basic cost containment and utilization management for patient care and facility operations. 10. Comply ... (EAP)** + **Paid Time Off (PTO)** + **Paid Holidays** **Impact lives with Management & Training Corporation (MTC) at the El Valle Detention Facility in Raymondville,… more
- Highmark Health (Austin, TX)
- …supporting, and optimizing the architectural strategy for **all clinical and utilization management applications** . Their expertise spans application, solution, ... and AI integration, extending this strategic oversight across **all clinical and utilization management applications** . This involves ensuring the completeness… more
- Humana (Austin, TX)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , or similar activities **Preferred ... industry, Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience in a medical management… more