- Molina Healthcare (Fort Worth, TX)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- BrightSpring Health Services (San Antonio, TX)
- Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic Supervisor for Youth ABA Line of Business MUST BE A FULLY LICENSED BCBA ... program development + Meet with school districts to provide current information on Spring Health Behavioral Health and Integrated Care Services + Explore… more
- Veterans Affairs, Veterans Health Administration (Corpus Christi, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants may not apply. Responsibilities ... The Intensive Community Mental Health Recovery Rural Access network for Growth Enhancement (ICMHR-RANGE)...and a part of the Veteran's recovery plan. Ensures utilization of government owned equipment (ie, laptop computers, phones,… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. ... Additional applications will be referred as needed. GS-11: Conducts mental health assessments to diagnose conditions and develop treatment plans. Provides… more
- Highmark Health (Austin, TX)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job works collaboratively riskacross Highmark Health clinical areas to support clinical ... Compliance Analyst is responsible for monitoring and analyzing medical and utilization management activities to ensure compliance with internal policies, state, CMS,… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... status of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of… more
- Highmark Health (Austin, TX)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more
- CenterWell (Austin, TX)
- …short-term interventions, and connection to community-based resources. This role brings behavioral health expertise and addresses social determinants of ... of an interdisciplinary team-particularly in partnership with primary care teams, community health workers, pharmacists, and behavioral health specialists.… more
- HCA Healthcare (Live Oak, TX)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed ... Northeast, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...of quality and cost improvement, and develops systems to review utilization of resources and objectively measure… more
- Highmark Health (Austin, TX)
- …designs, competitive position, product development, network options, strategic partnerships, utilization review , local/national client demographics and dentist ... confidentiality agreements. Monitor financial performance of contracts by tracking utilization and competitive environment, including group specific performance guarantees.… more