- Molina Healthcare (Houston, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… 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
- CVS Health (Austin, TX)
- …Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible medical management ... residence.** American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS Health....lower levels of care. + 1+ years' experience in Utilization Review. + CCM and/or other URAC recognized accreditation… more
- Molina Healthcare (TX)
- …including design, development, implementation, and oversight of technology that drives core utilization management , care management , long-term services and ... management /leadership experience in a clinical leadership, clinical systems and/or informatics, utilization management , or care management role. *… more
- Baylor Scott & White Health (Waco, 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: Waco, TX -** **100 Hillcrest Medical Blvd, Waco, 76712**… 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
- 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
- AON (Houston, TX)
- …and ability to work with others. + Experience in resource deployment and utilization management . + Successfully operates in a fast-paced driven environment that ... to work with others. + Experience in resource deployment and utilization management . + Successfully operates in a fast-paced driven environment that requires… more
- Health Care Service Corporation (Richardson, TX)
- …**2 years clinical experience of direct clinical care to the consumer.** ** Utilization management , discharge planning or managed care experience.** **Customer ... (housing, family support services).** **Provider side insurance experience.** **Familiarity with Utilization Management or Case Management activities and… more