- YesCare Corp (Waxahachie, TX)
- …measures including sentinel event review + Actively participant of the Utilization Review process and follow proper procedures. **YesCare Benefits** (only ... and paraprofessional staff. + Ensure and provide on-call services. + Annually review and approve clinical protocols, policies and procedures, and medical disaster… more
- CVS Health (Austin, TX)
- …with transferring patients to lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + ... AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support… more
- CVS Health (Austin, TX)
- …CISM experience. + Human Resource and/or Supervisory experience. + Case management, Utilization Review , or Utilization Management background preferred. ... **Education** + Master's degree in behavioral health field. **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $54,095.00 - $155,538.00 This pay range represents the base hourly rate or base annual… more
- HCA Healthcare (Houston, TX)
- …(5) years recent acute care experience required. Minimum of two (2) years of utilization review /case management experience and minimum of one (1) year experience ... score return to patient's baseline. + Maintains a balance of supplies for utilization during procedures while being cost conscious. + Is a customer service… more
- Evolent (Austin, TX)
- …to adeptly negotiate internally and externally around interpretation and application of utilization review law, accreditation standards and policy. + Ensures ... **What You Will Be Doing:** + Responsible for oversight of utilization management (UM)/care management (CM) correspondence development, internal and external… more
- Select Medical (Frisco, TX)
- …+ Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal ... time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate… more
- HCA Healthcare (San Antonio, TX)
- …Case Management will be performed. + Prefer at least one year experience in utilization review , resource management, discharge planning or case management. + RN ... functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts… more
- Baylor Scott & White Health (Temple, TX)
- …and pharmacy benefit management. This includes prescription drugs, benefits design, utilization review , formulary management, and cost containment strategies. + ... include service efficiencies, process standardization, drug formulary, and drug utilization . It also involves vendor selection, productivity, performance standards,… more
- HCA Healthcare (San Antonio, TX)
- …Preferred:Bachelor of Science in Nursing + At least one year experience in utilization review , resource management, discharge planning or case management. Prior ... functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts… more
- HCA Healthcare (El Paso, TX)
- …with patients and/or families as needed + You will complete accurate and timely utilization review of patient charts to insure appropriate utilization of ... hospital resources and facilities + You will provision clinical information to 3rd party payers in support of the patient's admission and/or continued hospital stay + You will have active communication with the physicians regarding issues such as length of… more