- Texas Tech University (Lubbock, TX)
- …space utilization & faculty collaboration. Participate in periodic space review analysis & research productivity reviews for WCOE facilities. Work with other ... safety protocols & policies for research activities. + Space Utilization - Assist Dean and Assoc Deans to ensure proper...western two-thirds of the state, Texas Tech University is home to 10 colleges, the Schools of Law and… more
- HCA Healthcare (Dallas, TX)
- …federal regulation pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement. + Conducts ... conference *Maintain insurance approval of patients in the Rehab unit. Manages the Utilization Review process and maintaining continued stay requirements for all… more
- Evolent (Austin, TX)
- …focusing on appeals and post-determination requests. We maintain the principles of utilization management by adhering to Evolent and Client policies and procedures ... work with a group of nurses, providing appeal intake review for one dedicated client. They interact with coordinators...Be Doing:** + Practices and maintains the principles of utilization management and appeals management by adhering to company… more
- Genesis Healthcare (Dallas, TX)
- …help older adults stay active and thrive while providing essential therapy for children at home and in school. With over 38 years of trusted service, our reach spans ... nursing centers, assisted and independent living facilities, outpatient clinics, and home -based care. We're proud to deliver personalized care exactly where and… more
- Molina Healthcare (Fort Worth, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... be licensed for the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer candidates with a… more
- CenterWell (Austin, TX)
- …+ Monitor plan performance and proactively bring issues to the forefront for review + Support new business implementations with a goal of ensuring all pharmacy ... and present to client + Escalate issues for immediate review and action whenever necessary + Request, review...internal partners and the Medicaid market to manage pharmacy utilization and spend + Manage escalated member, client and… more
- CVS Health (Austin, TX)
- …* Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. **Education** * Active and current ... effective use of health care resources. **This is a remote based (work from home ) role.** In this role has Medical Director (Behavioral Health) you will: * Provide… more
- HCA Healthcare (Dallas, TX)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... + Referral services for child, elder and pet care, home and auto repair, event planning and more +...the electronic health record (EHR) including: 1. standardization 2. utilization 3. integration 4. optimization The DCI is responsible… more
- Humana (Austin, TX)
- …with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health ... health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review … more
- Abbott (Plano, TX)
- …required clinical information for authorizations. + Work with respective carrier's utilization review department to obtain appropriate authorizations. + Assist ... insurance, Worker's Compensation and Medicare guidelines pertaining toProspective and Retrospective Utilization Review . Some experience in medical deviceor DME… more