- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- Terracon (Dallas, TX)
- …Supervise daily department operations including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, ... designated service line by providing training, inspections, and workforce/equipment utilization . + Partner with Director, Regional Operations and Operations Managers… more
- Molina Healthcare (Austin, TX)
- …team supporting non-clinical healthcare services activities for care management, care review , utilization management, transitions of care, behavioral health, ... within Molina's clinical/healthcare services function, which may include care review , care management, and/or correspondence processing, etc. * Researches and… more
- Terracon (College Station, TX)
- …operations of a department including staff training, development, and performance review , utilization of equipment and facilities, safety oversight, quality ... of services and work product, timely delivery of services and deliverables, and adherence to policies and procedure. Plan for and participate in business development activities to identify, develop, win, and execute project opportunities and build and maintain… more
- PDS Tech Commercial (Richardson, TX)
- …daily and weekly reports on schedule adherence, material shortages, and line capacity utilization for management review . **What We're Looking For** + **4 to ... 6** years of experience in a planning, material control, or scheduling support role within a manufacturing environment. + Foundational knowledge of the Electronics Manufacturing Services (EMS) or a similar high-tech assembly sector. Exposure to complex system… more
- Celestica (Richardson, TX)
- …and weekly reports on schedule adherence, material shortages, and line capacity utilization for management review . **Required Experience & Qualifications** + 4 ... to 6 years of experience in a planning, material control, or scheduling support role within a manufacturing environment. + Foundational knowledge of the Electronics Manufacturing Services (EMS) or a similar high-tech assembly sector. Exposure to complex system… more
- ChenMed (Houston, TX)
- …engagement with patient and family. + Facilitates patient/family conferences to review treatment goals and optimize resource utilization ; provides family ... assist in achieving desired clinical outcomes within specific timeframe. + Conducts review for appropriate utilization of services from admission through… more
- Burns & McDonnell (Houston, TX)
- …and guidelines to meet program management, global practice, and regional objectives. + Regularly review team utilization of staff to make sure employees have a ... clear path of development and support and those resources are adequately leveraged and empowered to their strengths and skillsets. + Oversight and management of chargeability and proper allocation of staff in the organization to meet regional KPI objectives.… more
- Actalent (Austin, TX)
- …+ Work with providers to approve determinations or provide recommendations based on review findings + Educate providers on utilization processes to ensure ... Clinical Review Nurse - Concurrent Review Location:...Trucare Cloud preferred) + Knowledge of Medicaid regulations and utilization management processes preferred + Proficiency in Microsoft Word,… more
- Datavant (Austin, TX)
- …healthcare. The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical ... author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers + Provide proper… more