- 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
- 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
- Baylor Scott & White Health (Waco, TX)
- …degree in nursing . Specialty Certification strongly encouraged. Knowledge of care management , resource and utilization management . Skilled in care ... quality outcomes by effectively managing care and resources to reduce unnecessary utilization . **Location: Waco, TX -** **100 Hillcrest Medical Blvd, Waco, 76712**… more
- UTMB Health (Galveston, TX)
- …and accurate information to payers. The role integrates and coordinates utilization management , care coordination and discharge planning functions. **Equal ... Care Manager TDCJ **Galveston, Texas, United States** **Hot** Nursing & Care Management UTMB Health Requisition # 2504032 **Minimum Qualifications:** RN with… more
- Elevance Health (Houston, TX)
- …criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Location: This role enables...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Elevance Health (Houston, TX)
- …required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care ... **Telephonic Nurse Case Manager II** **Hours: Monday - Friday...claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:**… more
- Veterans Affairs, Veterans Health Administration (Big Spring, TX)
- …functions including but not limited to Performance Improvement, Patient Safety, and Clinical/ Utilization Review and Management , Making decisions that reflect the ... registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an… more
- Apex Health Solutions (Houston, TX)
- …and cooperates with internal and external stakeholders. Collaborates effectively with Utilization Management , Quality Management , Pharmacy, Provider ... Summary Responsible for providing case management services and support to improve health outcomes...on a case by case basis Education Education: Registered Nurse (RN) LICENSES/CERTIFICATIONS: Registered Nurse (RN) with… more
- Molina Healthcare (TX)
- …at least 3 or more years in one or more of the following areas: utilization management , care management , care transitions, behavioral health, or equivalent ... work of external vendors. + Focuses on process improvement, organizational change management , program management and other processes relative to business needs.… more
- 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