- Highmark Health (Austin, TX)
- …expertise.This may include updating/revising existing medical policies. + Partner with Utilization Management and other operational teams to identify ... by internal/external partners. Conducts peer reviews as part of the quality review process. In addition to policy ownership, the incumbent participates in various… more
- Elevance Health (Grand Prairie, TX)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum requirements:** + Requires ... the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care… more
- Elevance Health (Houston, TX)
- …with providers, claims or service issues. + Assists with development of utilization /care management policies and procedures. **Minimum Requirements:** + Requires ... be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of licensure for members with complex and chronic care… more
- Baylor Scott & White Health (Temple, TX)
- …for assessing and coordinating patient care across the continuum to include case management , social work, utilization review and care coordination to ... ongoing problem solving related to care coordination, discharge planning, case management and utilization review . Monitors processes and systems to ensure… 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 . ... care. **Your responsibilities will include:** + Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies… 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 . ... care. Your responsibilities will include: + Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies… 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)
- …experience, preferably experienced in Oncology + Prefer at least one year experience in utilization review , resource management , discharge planning or case ... care. **Your responsibilities will include:** + Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies… more
- HCA Healthcare (San Antonio, TX)
- …Preferred: Bachelor of Science in Nursing + 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
- Baylor Scott & White Health (Plano, TX)
- …ROLE** Works with providers, departmental administration, making decisions to maximize provider utilization , and other management staff to create and/or revise ... role is the central point of communication for the utilization of all providers (greater than 40) within the...and/or clinical support ideas. Communicates with scheduling staff and management teams in a clear and professional manner any… more