- Fresenius Medical Center (Houston, TX)
- …supporting billing and collection activities. + Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... supply cost goals following all guidelines established in FMS formularies + Participates in the completion and interpretation of the Pl-17 inventory supply use analysis. + Reviews and approves facility payroll. + Reviews profit and loss statements with… more
- Fresenius Medical Center (Del Rio, TX)
- …+ Participates in cost control initiatives. Responsible for efficient utilization of medication, laboratory, inventory, supplies and equipment to achieve ... supply cost goals following all guidelines established in the formularies. + Assists in the development and revision of any applicable policies and procedures for the facility as directed to ensure continuous process improvement. + Initiates, documents and… more
- UTMB Health (Friendswood, TX)
- …quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review/Case Management program by utilizing clinical knowledge, expertise, approved ... FUNCTIONS_** **:** + Supervises the operational management of the Utilization Review/Case Management program to ensure high quality, cost...Nursing + Current Texas Nursing Licensure as a Registered Nurse (RN). + Minimum of five (5) years full-time… more
- Centene Corporation (Mcallen, TX)
- …Licensure required or + NP - Nurse Practitioner - Current State's Nurse Licensure required + Resource Utilization Group (RUG) certification must be obtained ... within 90 days of hire required Pay Range: $35.49 - $63.79 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible… more
- Houston Methodist (Sugar Land, TX)
- …the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management and ... team partners. This position uses sound clinical judgement in the Utilization Management process and knowledge of regulatory requirements to make appropriate… more
- Molina Healthcare (Fort Worth, TX)
- …and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource ... management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality of patient care,… more
- Humana (Austin, TX)
- …for evolving Humana's Utilization Management of medical review by physician or nurse , with a focus on our 5+ million Medicare members. You will also facilitate ... The Director, Physician leadership will lead Medical Directors performing utilization management for inpatient authorizations training medical director team to… more
- Select Medical (Fort Worth, TX)
- …May Apply** **Responsibilities** Under the direction of the Chief Nursing Officer (CNO)/ Nurse Manager (if position applies within hospital), the Nurse Supervisor ... of care under the direction of the Chief Nursing Officer/ Nurse Manager. May provide oversight for the hospital in...of the nursing process and in the development and utilization of the interdisciplinary care plan for all patients.… more
- Houston Methodist (Houston, TX)
- …most clinically appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs ... excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for appropriate… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted ... issuing Medicare Hospital Initiated Notice of Non-coverage. + Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource… more