- MD Anderson Cancer Center (Houston, TX)
- …Houston is one of the world's most respected centers focused on cancer patient care , research, education and prevention. It was named the nation's No. 1 hospital for ... cancer care in US News & World Report's 2024-2025 rankings....reports quality improvement data in a format that facilitates review by the division CQI committee. * Maintains knowledge… more
- CenterWell (Eastland, TX)
- …review of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and ... community and help us put health first** The **Clinical Manager ** coordinates and oversees all direct care ...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Houston Methodist (Sugar Land, TX)
- …approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Reviews level of care ... effectively. Proactively takes action to achieve continuous improvement and expedite care /facilitate discharge. + Performs post-discharge review by analyzing the… more
- Houston Methodist (The Woodlands, TX)
- …approved utilization criteria to monitor appropriateness of admissions, level of care , resource utilization , and continued stay. Reviews level of care ... for hospital services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and… more
- Healthfirst (TX)
- The Case Manager , Utilization Management coordinates the care plan for assigned members and conducts pre-certification, concurrent review , discharge ... planning, and case management as assigned. The Case Manager , Utilization Management is also responsible for...care options, and discharge planning + Certified Case Manager + Interqual and/or Milliman knowledge + Knowledge of… more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... for life - and empowers their passion for patient care . Apply today for our RN Case Manager...approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay… more
- CVS Health (Arlington, TX)
- …+ Field Experience. + Bilingual. + Crisis intervention skills preferred. + Managed care / utilization review experience preferred. + Case management and ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
- HCA Healthcare (Austin, TX)
- …Eligibility for benefits may vary by location._** Come join our team as a(an) Contracts Manager . We care for our communities and employees! HCA Hope Fund in ... history, volumes, utilization ), coverage and scope of services. The Contract Manager will also collaborate with contractors and leadership to address and resolve… more
- Parsons Corporation (San Antonio, TX)
- …on workflow efficiency, and maintaining research documents. Additionally, the Program Manager II will assist with space utilization , financial tracking, ... got what you're looking for. **Job Description:** Parsons is seeking a **Program Manager II** to support Naval Medical Research Unit - San Antonio (NAMRU-SA) and… 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 ... care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of...compelling, we encourage you to apply for our Case Manager RN opening. We promptly review all… more