- 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 ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… 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 +...in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement… more
- HCA Healthcare (Kingwood, 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 +...patients achieve optimal health, access to care, and appropriate utilization of resources, balanced with the patient's resources and… more
- Houston Methodist (The Woodlands, TX)
- …planning process on assigned units. + Initiates and facilitates referrals for home health care, hospice, and durable medical equipment. Consults with Social Worker ... patient satisfaction and safety measures. **FINANCE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,… more
- Houston Methodist (Houston, TX)
- …data management support to the department staff to facilitate efficient utilization of resources including referrals management, communication and collaboration with ... Medicare, Medicaid, and managed care reimbursement methodologies** + **Ability to review clinical documentation for Medical Necessity and payer requirements** +… 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 organization,… more
- CVS Health (Austin, TX)
- … Review Organization a Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience -Electronic medical systems/record ... Virginia and West Virginia. This Medical Director will be a "Work from Home " position primarily supporting Aetna Better Health of Texas. The Medical Director is… more
- Humana (Austin, TX)
- …involvement in day-to-day UM activities and discussions with UM leaders. 20% 2. Review and monitor Contract Change Orders and evaluate impact on Utilization ... related medical field + Minimum of 5 years experience utilizing medical necessity review criteria (EG MCG, InterQual) + **Our Department of Defense Contract requires… more
- HCA Healthcare (Round Rock, TX)
- …protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, ... and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity… more
- HCA Healthcare (Fort Worth, 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 +...rational drug therapy and make improvements identified by drug utilization evaluations + Provide accurate and timely medication information… more