• Representative, Dental Provider Services

    Molina Healthcare (Fort Worth, TX)
    …physicians. Such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding, for ... position is February.** **Job Summary** Molina Health Plan Provider Network Management and Operations jobs are responsible for network development, network adequacy… more
    Molina Healthcare (12/31/25)
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  • Case Manager - PRN

    Select Medical (Denton, TX)
    …allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and ... of the discharge planning process. + The primary job functions in Case Management include: + Clinical Interventions/Discharge Planning + Care Planning Management more
    Select Medical (12/11/25)
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  • VP & Medical Director

    Travelers Insurance Company (Austin, TX)
    …skills **What is a Must Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board of Medical Specialties ... to keep Travelers at the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work as soon as medically… more
    Travelers Insurance Company (10/24/25)
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  • Legal Counsel, Carelon Contracting

    Elevance Health (Grand Prairie, TX)
    …of the Carelon Services businesses, including behavioral health, medical benefits utilization management , specialty care solutions, and care delivery companies. ... and legal colleagues to harmonize, centralize, and improve existing contract management workflows and policies across the Carelon Services businesses. + Become… more
    Elevance Health (12/30/25)
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  • Licensed Vocational Nurse

    MTC (Raymondville, TX)
    …clean; utilize appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... PTO and 11 paid holidays + Employee assistance program Management & Training Corporation (MTC) is proud to operate...with an acceptable driving record required, unless waived by management . _Management & Training Corporation (MTC) is an Equal… more
    MTC (12/13/25)
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  • Dentist

    MTC (Anson, TX)
    …of all patients' medical records. + Implement basic cost containment and utilization management for patient care and facility operations. + Comply ... perform other duties as assigned within his/her capabilities as determined by management . **Education and Experience Requirements:** Requires DDS or DMD degree and… more
    MTC (12/12/25)
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  • Registered Nurse

    MTC (Livingston, TX)
    …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... plan **Make a Difference Where It Matters!** Operated by Management & Training Corporation, the **IAH Detention Facility in...with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is… more
    MTC (12/07/25)
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  • Representative, Provider Relations HP - Remote

    Molina Healthcare (Dallas, TX)
    …example, such meetings would occur to discuss and resolve issues related to utilization management , pharmacy, quality of care, and correct coding. * ... and contracted provider network. They are responsible for network management including provider education, communication, satisfaction, issue intake, access/availability… more
    Molina Healthcare (11/28/25)
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  • Quality Outcomes Specialist - Houston Methodist…

    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 ... Conducts record review for performance improvement, peer review, patient safety, risk management and other projects. + Facilitates and leads process and performance… more
    Houston Methodist (12/27/25)
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  • Registered Nurse III

    MTC (Raymondville, TX)
    …the use of appropriate sanitation methods. + Practice basic cost containment and utilization management for detainee care and facility operations. + Maintain ... of Texas with an acceptable driving record required, unless waived by management . Management & Training Corporation (MTC) is an Equal Opportunity Employer. All… more
    MTC (12/25/25)
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