- Actalent (Austin, TX)
- …systems + Work with providers to approve or recommend determinations based on review findings + Educate providers on utilization processes to ensure high-quality ... Clinical Review Nurse - Concurrent Review Location:...preferred) + Knowledge of Medicaid or Medicare regulations and utilization management processes + Proficiency in Microsoft Word, Excel,… more
- Molina Healthcare (Fort Worth, TX)
- …we are seeking a TX licensed Occupational Therapist to join the utilization management team conducting reviews for cases requiring OT services. Preference will ... you apply to this role. Job Summary Provides support for member services review assessment activities for a specific area of specialty. Responsible for ensuring that… more
- Molina Healthcare (San Antonio, TX)
- …on set schedule) Looking for a RN with experience with appeals, claims review , and medical coding. JOB DESCRIPTION Job SummaryProvides support for clinical member ... services review assessment processes. Responsible for verifying that services are...to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications *… more
- Molina Healthcare (Dallas, TX)
- JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Molina Healthcare (Houston, TX)
- JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At least 2… more
- Texas A&M University - Faculty (College Station, TX)
- Tenure-Track/Tenure Review Upon Hire: Open Rank (Assistant Professor, Associate Professor, Full Professor) Pharmaceutical Sciences Location College Station Open Date ... Pharmacy in the Department of Pharmaceutical Sciences. This is an 11-month, tenure-track/tenure review upon hire position in College Station , and the start date is… more
- Actalent (Austin, TX)
- …+ Monitor project budgets and analyze profitability, revenue, margins, billing rates, and utilization . + Conduct regular team meetings to review progress and ... with Survey Service Leader and Market Leaders on staffing, workload management, and utilization planning. + Work with division and market leadership to expand the… more
- Molina Healthcare (San Antonio, 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
- Molina Healthcare (Fort Worth, TX)
- …Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and chemical ... Health care management programs. **Knowledge/Skills/Abilities** Provides Psychiatric leadership for utilization management and case management programs for mental health… more
- Colliers Engineering & Design (Austin, TX)
- …and communicate effectively with all employees involved in the project to ensure high utilization rates (ie Project team meetings). + Review monthly man-hour and ... man power needed on projects. + Hold team meetings ensuring procedures governing review and approval of projects are followed prior to submission of completed work.… more