- 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
- 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)
- …program. Preferred:Bachelor of Science in Nursing + At least one year experience in utilization review , resource management , discharge planning or case ... 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)
- …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
- Austin Industries (Irving, TX)
- …of the crafts in an efficient manner, allocation of manpower, materials, equipment utilization , overall management of the project safety plan and overall ... guarantee high-quality workmanship + Self-performed labor, material and equipment cost management + Manage crews, equipment, material resources, and subcontractors +… more
- Elevance Health (Houston, TX)
- …ACMP experience is preferred. + Medical Management experience is preferred, + Utilization Review experience is preferred. + Knowledge of the medical ... states; therefore, Multi-State Licensure will be required.** The **Medical Management Nurse** is responsible for review of...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more
- Humana (Austin, TX)
- …criteria or comparable (such as Interqual, etc.) **Preferred Qualifications** + Utilization Review /Quality Management experience + BA/BSN degree ... patient's care. Coordinate patient transfers and document appropriately in MSR. Review inpatient outlier cases, ensure appropriate and timely discharge planning, and… more
- Datavant (Austin, TX)
- …and software tools. The specialist serves as a key liaison between coding, billing, utilization review , case management , and payer relations to reduce ... record (EHR) systems. + Collaborate with internal departments (HIM, billing, case management , patient access) to investigate and resolve complex denials. + Utilize… more
- Sedgwick (Austin, TX)
- …satisfaction; to ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple ... business lines; and to provide expertise in client specific case management and utilization review requirements and ensure customer satisfaction through the… more
- Deloitte (San Antonio, TX)
- …+ Assistance in financial management of client engagements, project management through utilization of project management tools. Qualifications ... with Audit Client's methodology and estimates. + The detailed review of Audit Client's methodology used to develop estimates...all parties updated on progress. + Oversight and project management of junior actuaries and staff work streams, while… more
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