- Molina Healthcare (San Antonio, TX)
- …suite/applicable software program(s) proficiency. Preferred Qualifications * Utilization management , care management , behavioral health and/or long-term ... Job Duties * Performs audits of non-clinical staff in utilization management , care management , member...services and supports (LTSS) non-clinical review /auditing experience. To all current Molina employees: If you… more
- Houston Behavioral Healthcare Hospital (Houston, TX)
- …The Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management ... Houston Behavioral Healthcare Hospital (HBHH) is unique in so...ready to provide exceptional service. The team at Houston Behavioral Healthcare Hospital strives to be the leaders in… more
- Molina Healthcare (Houston, TX)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health ... assists with implementing integrated Behavioral Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization… more
- Health Care Service Corporation (Richardson, TX)
- …Reviews And Telephone Reviews With Facility Ur Personnel. Additional Duties Include: Review Of "Cases" With Care Management Professional Staff (Case ... telephone reviews with facility UR personnel. Additional duties include review of "cases" with care management professional...in good standing. + 5 years clinical experience in behavioral health care management . + Located in… more
- Elevance Health (Grand Prairie, TX)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... ** Behavioral Health Medical Director-Psychiatrist Appeals** **Location:** This role...Experiences:** + Child and Adolescent experience strongly preferred. + Utilization Management experience. + Applied Behavior Analysis… more
- Elevance Health (Houston, TX)
- …services only, and there is licensed staff supervision. + Previous experience in case management / utilization management with a broad range of experience with ... ** Behavioral Health Care Manager II** **Virtual** : This...professional treatment health benefits through live telephonic or written review . **How you will make an impact:** + Uses… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... 3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active,… more
- Molina Healthcare (Houston, TX)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... with PEGA helpful. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- Molina Healthcare (Houston, TX)
- …Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG ... guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Elevance Health (Grand Prairie, TX)
- …to clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the ... means that the medical director is directly involved in Utilization Management and Case Management ....state or territory of the United States when conducting utilization review or an appeals consideration and… more