- Evolent (Austin, TX)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Humana (Austin, TX)
- …quality management, utilization management, case management, discharge planning and/or home health or post-acute services such as inpatient rehabilitation ... management, provider relations, quality of care, audit, grievance and appeal and policy review . The Behavioral Health Medical Director will develop and present… more
- Evolent (Austin, TX)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... for select health plans or regions, assuming overall accountability for utilization management while working in conjunction with the SVP, CCO and/or CMO. +… more
- CVS Health (Austin, TX)
- …for an Independent Review Organization a Plus **Preferred Qualifications:** - Health plan/payor Utilization Management / Review experience -Electronic ... Texas, Virginia and West Virginia. This Medical Director will be a "Work from Home " position primarily supporting Aetna Better Health of Texas. The Medical… more
- Evolent (Austin, TX)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Evolent (Austin, TX)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Evolent (Austin, TX)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... selecting health plans or regions, assuming overall accountability for utilization management while working in conjunction with the Senior Medical Director.… more
- Humana (Austin, TX)
- …quality management, utilization management, case management, discharge planning and/or home health or post-acute services (such as inpatient rehabilitation). ... insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization,… more
- HCA Healthcare (Live Oak, TX)
- …a data-driven environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care in ... support for appeals and denials process, discharge planning, case management, and utilization review /management + You will consult with facility-level staff… more
- Veterans Affairs, Veterans Health Administration (Corpus Christi, TX)
- …establishing, and implementing policies and procedures for the Primary Care Mental Health Integration (PCMHI) Program; supervising PCMHI, Home -Based Primary Care ... to all PCMHI Service staff, as appropriate. Provides general supervision for PMCHI, Home Based Primary Care, and other health -focused clinical staff and… more