- Molina Healthcare (Dallas, TX)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... and quality initiatives under the direction of leadership. + Monitors drug utilization and assists leadership team in understanding quality and cost control issues… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management-Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... leader for system services for wholly owned and Partner hospitals for utilization management. Job Duties OPERATIONS: Plans, organizes and delegates activities as… more
- Elevance Health (Grand Prairie, TX)
- ** Utilization Management Representative II** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training ... unless an accommodation is granted as required by law._ The ** Utilization Management Representative II** is responsible for managing incoming calls, including… more
- Conduent (Plano, TX)
- … Hybrid- 3 days in office 2 days remote** **Overview:** **An Operation's Manager oversees the utilization of the organization's Business Analyst team who ... serve as primary liaisons between internal and/or external customers and Information Technology Teams (IT) to define business requirements for systems fixes and enhancements to meet customer and organizational objectives and needs.** **Job Description:**… more
- Baylor Scott & White Health (Dallas, TX)
- …in discharge planning, setting case management referral standards, reviewing utilization , and categorizing levels of care. + Excellent communication skills ... documentation systems. + Case management certifications, such as Certified Case Manager , are beneficial but not necessary for this position. **Belonging Statement-**… more
- Texas Health Resources (Arlington, TX)
- Registered Nurse (RN) - Case Manager - PRN Work location: Texas Health Arlington 800 W. Randol Mill Road TX 76012 Work hours: PRN - Weekend/Evening Shift Department ... physician and payor. 6. Coordinates care with unit case manager and interdisciplinary team. 7. Documents the provision of...and continuity of care to prevent readmission. 35% C. Utilization Review: 1. Performs utilization review according… more
- HCA Healthcare (Houston, TX)
- …**Introduction** Do you have the career opportunities as a Registered Nurse Case Manager you want in your current role? We invest in what matters most ... Qualifications** + Under the direction of the Case Management Manager and the Director of QRM, reviews admissions and...in accordance with procedures set forth in the Hospital Utilization Management Plan and the criteria and standards approved… more
- HCA Healthcare (Houston, TX)
- …any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** HCA Houston Healthcare Medical Center, ... passion for patient care. Apply today for our Registered Nurse Case Manager opportunity. **Job Summary and Qualifications** In collaboration with the patient/family,… more
- Molina Healthcare (TX)
- …of illness and the site of service. **KNOWLEDGE/SKILLS/ABILITIES** The Manager , Healthcare Services provides operational management and oversight of integrated ... performing one or more of the following activities: care review/ utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), case… more
- Parsons Corporation (San Antonio, TX)
- …on workflow efficiency, and maintaining research documents. Additionally, the Program Manager II will assist with space utilization , financial tracking, ... got what you're looking for. **Job Description:** Parsons is seeking a **Program Manager II** to support Naval Medical Research Unit - San Antonio (NAMRU-SA) and… more
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