• Medical Director

    Elevance Health (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 ... a State agency.*_ **Preferred Skills, Capabilities and Experiences:** + 1-2 years Utilization Management experience strongly preferred. + Strong oral, written,… more
    Elevance Health (09/29/25)
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  • Supv Comprehensive Care SW

    Baylor Scott & White Health (Dallas, TX)
    …daily activities and staff. They assess and coordinate patient care, including case management , social work, utilization review , and care coordination. The ... Factors** + Knowledge of care coordination, discharge planning, case management and utilization review . +...involves psychosocial methods and the assessment and treatment of behavioral and affective disorders. + Know the standards and… more
    Baylor Scott & White Health (09/07/25)
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  • UR Coordinator

    San Antonio Behavioral Health (San Antonio, TX)
    The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... status of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of… more
    San Antonio Behavioral Health (09/27/25)
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  • RN Case Manager PRN Inpatient Rehab

    HCA Healthcare (Dallas, TX)
    …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
    HCA Healthcare (08/09/25)
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  • Part-Time Weekend Medical Director (Remote)

    Highmark Health (Austin, TX)
    …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
    Highmark Health (09/11/25)
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  • Advanced Clinical Pharmacist

    HCA Healthcare (San Antonio, TX)
    …and actively participating in daily multidisciplinary and bedside rounds, completing drug utilization review to promote rational drug therapy, leading and ... for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services...rational drug therapy and make improvements identified by drug utilization evaluations. + You will provide accurate and timely… more
    HCA Healthcare (09/19/25)
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  • Clinic Social Worker Intake

    AdventHealth (Killeen, TX)
    …weekend **Location:** Emergency Department **The role you'll contribute:** + AdventHealth Behavioral Health Center (AHHC) Clinical Social Worker position is a ... group therapies; completing comprehensive psychosocial assessments; executing clinical case management tasks; and ensuring patients and family members receive… more
    AdventHealth (08/20/25)
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  • Director of Clinical Services

    San Antonio Behavioral Health (San Antonio, TX)
    … and communication to ensure effective and efficient department operation . Review caseloads regularly to ensure appropriate utilization of services . ... When patient needs are not met, acknowledge and work to resolve complaints . Review caseloads regularly to ensure appropriate utilization of services . Monitors… more
    San Antonio Behavioral Health (08/16/25)
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  • Associate Medical Director-Dallas

    CenterWell (Fort Worth, TX)
    …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
    CenterWell (08/12/25)
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  • Associate Medical Director- Dallas

    CenterWell (Arlington, TX)
    …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
    CenterWell (07/18/25)
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