- Molina Healthcare (Austin, TX)
- …with NCQA file review standards and surveyor interactions. + Experience with conducting Utilization Management and Population Health Management file audits, ... system analysis and program staff. These positions' primary focus is project/program management . **Job Duties** **Program Oversight & Project Management ** +… 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 ... as the need arises. **EDUCATION** + Bachelor's degree in nursing + Master's degree preferred **WORK EXPERIENCE** + Four...**LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse - Texas State Licensure -- Compact Licensure -… more
- UTMB Health (Lovelady, TX)
- …information and records at all times. + Practices basic cost containment and utilization management for patient care and facility operations. + Prioritizes and ... Testing. + Assists with patient activities and care as assigned by the charge nurse /designee as indicated by the patient's plan of care. + Provides for patients'… more
- Molina Healthcare (Austin, TX)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At ... managed care, or equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in state of practice.… more
- Elevance Health (Grand Prairie, TX)
- …Manager I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder ... work counseling or a related behavioral health field or a degree in nursing , and minimum of 3 years of experience with facility-based and/or outpatient psychiatric… more
- Evolent (Austin, TX)
- …a key clinical executive responsible for leading cardiology- and vascular-related utilization management , quality improvement, and clinical operations across ... highly desirable + 7+ years managing teams to drive performance across physician, nursing , and shared services teams + 3+ yearsworking with clinical operations in a… more
- HCA Healthcare (San Antonio, TX)
- … Management will be performed. + Prefer at least one year experience in utilization review, resource management , discharge planning or case management . + ... functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts… more
- HCA Healthcare (San Antonio, TX)
- …Management will be performed. + Prefer at least one year experience in utilization review, resource management , discharge planning or case management . ... functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts… more
- HCA Healthcare (San Antonio, TX)
- …of Science in Nursing + At least one year experience in utilization review, resource management , discharge planning or case management . Prior ... functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts… more
- HCA Healthcare (San Antonio, TX)
- …Bachelor of Science in Nursing + At least one year experience in utilization review, resource management , discharge planning or case management . Prior ... functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts… more