- Humana (Austin, TX)
- …of services provided by other healthcare professionals in compliance with review policies, procedures, and performance standards. Represents Humana at Administrative ... on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with health insurance organizations,… more
- HCA Healthcare (Houston, TX)
- …responsibility typically includes Accounting, Reimbursement, Managed Care, Health Information, and Utilization Review . Functions at an executive level in an ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- Veterans Affairs, Veterans Health Administration (Corpus Christi, TX)
- …the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA Careers - Psychologist: ... the Primary Care Mental Health Integration (PCMHI) Program; supervising PCMHI, Home -Based Primary Care (HBPC) staff and other health-focused clinical positions; and,… 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 ... protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage,… more
- HCA Healthcare (San Antonio, 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 (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
- CenterWell (Fort Worth, TX)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to improve… more
- Prime Healthcare (Mesquite, TX)
- …plans, including referrals to rehab, home health, or long-term care facilities + Utilization Review : m onitor the use of hospital resources and services to ... to manage care transitions. RN Case Managers also conduct discharge planning, utilization review , and helping patients navigate insurance and healthcare systems.… more
- CenterWell (Arlington, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to align with… more
- MD Anderson Cancer Center (Houston, TX)
- …team concerning home care, potential problems, emotional concerns or utilization review status. Participates in regularly scheduled team conferences and ... Remains abreast of developments in the field of nursing or utilization review by attending seminars and workshops, communicating with peers, and reading… more