• National Accounts Medical Director

    Elevance Health (Grand Prairie, TX)
    …members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the clinical relevance to ... use of medical services by members. Involved in identifying and managing medical utilization trends, emerging trends and market changes that impact the client and… more
    Elevance Health (09/23/25)
    - Related Jobs

  • Pharmacist, Clinical/Medication Therapy Management…

    Molina Healthcare (Fort Worth, TX)
    …authorization requests as needed. * Researches, develops, and implements drug utilization and disease state management strategies and intervention techniques to ... staff, and providers. * Reviews and analyzes Pharmacy Benefit Manager (PBM) reports to track general trends in drug... (PBM) reports to track general trends in drug utilization and identify potential targeted utilization management… more
    Molina Healthcare (09/24/25)
    - Related Jobs

  • Medical Director, Behavioral Health (NE)

    Molina Healthcare (Houston, TX)
    …oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical ... working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
    Molina Healthcare (10/03/25)
    - Related Jobs

  • Transfer Center Point of Entry Nurse - Mid Shift

    Houston Methodist (Houston, TX)
    …units through the facilitation and coordination of patient flow and bed utilization . The POE Nurse position collaborates with clinical staff and interprofessional ... health care team to ensure resource utilization is appropriate to the patient's clinical needs and...and special request concerning each patient. Coordinates with case manager to escalate cases. + Demonstrates teamwork by awareness… more
    Houston Methodist (07/21/25)
    - Related Jobs

  • Special Operations Physical Therapist 528th…

    KBR (Houston, TX)
    …USSOCOM HQ and POTFF Staff, and as directed by local HP program manager and/or coordinator. + Document work performed, utilization , encounters, referrals, ... specialty providers . + If directed by HP Program Manager and/or Coordinator, directly supervise the PT Tech, PT...of care. + Provide input for the development and utilization of required databases. + Conduct peer (record) review… more
    KBR (09/24/25)
    - Related Jobs

  • Tax Specialist

    ADP (El Paso, TX)
    …SUMMARY:** The Implementation Specialist Job Family acts as a consultant and project manager to new and existing small business clients as they transition to ADP. ... a welcome call to ensure optimum product awareness and utilization , and sets overall expectations. As client status updates...mentor, coach, and provide guidance to peers. + Support manager and add to bench strength. + Understands how… more
    ADP (10/03/25)
    - Related Jobs

  • Scheduler Lead

    HCA Healthcare (Houston, TX)
    …Summary and Qualifications** Under the general supervision of the Pre-Admit Manager , performs support services for the department, assigned clerical, secretarial, ... and related responsibilities, promoting communication between the Director, Manager , medical staff, hospital staff, and patients. Provides effective scheduling by… more
    HCA Healthcare (07/12/25)
    - Related Jobs

  • Sr. Clinical Sales Executive - Central Region

    Danaher Corporation (Dallas, TX)
    …is required. This position reports to the Sr. National Clinical Sales Manager and is part of Beckman Coulter Diagnostics commercial organization working remotely ... care improvement opportunities including but not limited to early id, resource utilization in high scrutiny workflows, and antibiotic stewardship. + The CSE will… more
    Danaher Corporation (10/02/25)
    - Related Jobs

  • Nurse Reviewer I

    Elevance Health (Houston, TX)
    …ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or ... required. **Preferred Experience, Skills, and Capabilities:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health… more
    Elevance Health (09/26/25)
    - Related Jobs

  • LTSS Service Coordinator

    Elevance Health (Corpus Christi, TX)
    …chronic illnesses, co-morbidities, and/or disabilities, to ensure cost effective and efficient utilization of long-term services and supports. + At the direction of ... and may be involved in process improvement initiatives. + Submits utilization /authorization requests to utilization management with documentation supporting and… more
    Elevance Health (08/09/25)
    - Related Jobs