- Sedgwick (Austin, TX)
- …use contract with client. + Maintains accurate record system of pharmacy utilization review and complex pharmacy reviews to include cost savings, trends, and ... data collection. + Interacts and coordinates work of physician advisors as needed; performs complex review of cases...complex review of cases to identify referral for case management as needed. + Participates in client meetings and… 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
- CVS Health (Richardson, TX)
- …affirmative action employer, and is an equal opportunity employer, as are the physician -owned businesses for which CVS Health provides management services. We do ... not only meet but exceed business needs. **_KEY RESPONSIBILITIES_** + **Expert Management ** : Maintain and manage a comprehensive suite of multi-vendor z/OS software… more
- HCA Healthcare (Austin, TX)
- …**Job Summary and Qualifications** The Contract Manager is responsible for the management of the Central Texas market contract department. Duties include supervising ... may include: payor mix, historical volume data (prior payment history, volumes, utilization ), coverage and scope of services. The Contract Manager will also… more
- 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 ... the leading edge of the P&C industry. Develop medical management strategies that help injured employees return to work...+ Provide overall program leadership as the organization's lead physician . Serve as the key enabler and facilitator for… more
- CVS Health (Austin, TX)
- …You can have life-changing impact on our members, who are enrolled in Care Management and present with a wide range of complex health and social challenges. With ... exciting opportunity as we grow and expand our Care Management Programs to change lives in new markets across...assists with securing DME, and helps to ensure timely physician follow-up. - Understands Payer/Plan benefits, policies, procedures, and… more
- Houston Methodist (Houston, TX)
- …rules and regulatory guidelines. This position serves as the liaison between management , staff and physicians for routine matters, resolving questions and issues. ... review coded accounts for accuracy. Serves as liaison between team members, management and physicians resolving routine matters, informing or escalating to … more
- Houston Methodist (Houston, TX)
- …transplantation. Primary responsibilities for this position include logistics management , preservation, packaging and labeling of organs for transplantation; ... acceptance/rejection for transplant and prepares a thorough report for the physician to review. Facilitates admission/transfer of recipient for transplantation and… more
- UTMB Health (Galveston, TX)
- …examinations to include non-invasive cardiac and vascular testing, transesophageal procedures, utilization of contrast for cardiac echo as required by laboratory ... protocol and physician order. - Determines the most appropriate testing techniques...Technical Director and assists in implementation of total quality management program for the Echocardiography/Vascular Laboratory. - Practices safety… more
- Houston Methodist (Houston, TX)
- …resource for department staff and coordinating department education in partnership with management . **PEOPLE ESSENTIAL FUNCTIONS** + Serves as a content expert and ... and clinical judgment; treats acute/chronic medical problems, as per physician approved protocol. Administers ordered medications via oral, subcutaneous,… more