- Austin Industries (Irving, TX)
- …existing equipment platform and refine and develop and implement new Infrastructure based utilization and management program + Participate in the development of ... **Texas area.** The Equipment Service Manager is responsible for maximizing the utilization of Austin Bridge and Road's equipment across the project spectrum.… more
- CenterWell (Austin, TX)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent ... community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or Bachelor's degree in a related field +… more
- Evolent (Austin, TX)
- …billing and various sites of care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical ... member-centric products. This role plays a critical part in both **Medical Cost Management ** and **Product Management ** , leveraging advanced analytics to solve… more
- Evolent (Austin, TX)
- …critical role in **Performance Suite risk arrangements with payers and strategic utilization management initiatives.** This is an opportunity for a ... developing cardiovascular programs that include improvements to clinical effectiveness of utilization management (UM) and risk-based models.** + Process… more
- Molina Healthcare (San Antonio, TX)
- …of payment decisions. + Serves as a clinical resource for Utilization Management , Chief Medical Officers, Physicians, and Member/Provider Inquiries/Appeals. ... ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review. + Minimum two years of experience in… more
- Intermountain Health (Austin, TX)
- …cost-effective outcomes. Provides focused support to various areas such as utilization management , emergency department, acute, ambulatory and specialty care. ... in examining patterns of health care needs, decisions, lifestyle choices, and utilization of resources that affect their health. + Advocates, educates and coaches… more
- Evolent (Austin, TX)
- …design and implement intuitive, efficient, and engaging user interfaces for our Utilization Management health care workflow applications. User research and ... with health care software development methodologies and lifecycles + Experience with utilization management and/or prior authorization processes is preferred +… more
- Insight Global (Houston, TX)
- Job Description Insight Global is seeking 10 Correspondence Processors to join the Utilization Management team to help with the influx of membership growth. To ... - Care Review, Care Coordinator, Medical Assistant, Patient Services, Utilization Review, Authorization, Eligibility, Claims, Member Services, Patient, Provider,… more
- Molina Healthcare (Houston, TX)
- …Medical, or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina ... **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN in the state of Texas. You will be hired to join the inpatient review team doing initial and… more
- Molina Healthcare (Fort Worth, TX)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal… more