- Fresenius Medical Center (Paris, 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
- 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 (TX)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure ... most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and under-… more
- Houston Methodist (Houston, TX)
- …strategic oversight for all hospital-based Case Management Directors and the Central Utilization Review Director across the system. This position is responsible for ... initiatives aimed at optimizing patient progression of care, aligning utilization review practices, enhancing discharge planning processes, and strengthening… more
- Molina Healthcare (San Antonio, TX)
- …in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), ... Job Duties * Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with… more
- Baylor Scott & White Health (Waxahachie, TX)
- …2 bed recovery room (or converted to 4 bed triage room), 2 ORs **Patient Ratio:** L&D 1 nurse to 2 patients, 1 nurse OR 1 labor patient & 1 triage/1 nurse ... 10 labor rooms and a 3 bed OBED** **Preferred Experience:** -Triage nurse competency. -Circulator nurse competency. -Certified in obstetrics. -NRP (preferred… more
- Baylor Scott & White Health (Temple, TX)
- …patient care across the continuum to include case management, social work, utilization review and care coordination to achieve optimal clinical and quality outcomes ... by effectively managing care and resources to reduce unnecessary utilization . **Location: Temple, TX - Baylor Scott & White...5 Years of Experience - CERTIFICATION/LICENSE/REGISTRATION - & Registered Nurse (RN) As a health care system committed to… 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
- Molina Healthcare (Houston, TX)
- …in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), ... Job Duties * Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with… more
- CenterWell (Amarillo, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts ... identifies and evaluates alternative courses of action through the utilization of Performance Improvement principles. + Responsible for review...of Nursing. + Current state license as a Registered Nurse . + Proof of current CPR. + Valid driver's… more