- Molina Healthcare (Austin, TX)
- …, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + Experience ... and interacts with network and group providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource… more
- CVS Health (Austin, TX)
- At CVS Health , we're building a world of health ...lower levels of care. + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized ... ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health ...day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.**… 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 ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...Radiology you will be a key member of the utilization management team. We can offer you a meaningful… 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 ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...Oncology, you will be a key member of the utilization management team. We can offer you a meaningful… more
- BrightSpring Health Services (San Antonio, TX)
- Our Company SpringHealth Behavioral Health and Integrated Care Overview Behavior Clinic Supervisor for Youth ABA Line of Business MUST BE A FULLY LICENSED BCBA IN ... professional teams. Provide staff/family training on implemented programs. + Review all Functional Behavior Assessments/Behavior Support Plans prior to… more
- Catholic Health Initiatives (Houston, TX)
- …Staff and the market MSO director to lead credentialing, privileging, and peer review . + Set strategic direction for the areas mentioned above, which includes ... to conduct the work of clinical operations, clinical integration, and population health management. Collect and share group trend data on resource utilization… more
- HCA Healthcare (Houston, TX)
- …Woman's Hospital of Texas, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and programs ... cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.… more
- Catholic Health Initiatives (Houston, TX)
- …the referral and evaluation process for potential transplant candidates. Review medical information, schedule testing including physician and coordinator ... consultations, collect data, review results and compile data for presentation of patient's...collaborating with the entire team to control LOS, ICU utilization and document variances. + Serve as a clinician… more
- CVS Health (Austin, TX)
- …consistent responses to members and providers. Leads all aspects of utilization review /quality assurance, directing case management Provides clinical expertise ... At CVS Health , we're building a world of health around... care resources. **This is a remote based (work at home ) based anywhere in the US.** Aetna, a CVS … more
- Texas Health Resources (Dallas, TX)
- …and top-notch benefits? We're looking for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health Dallas + Core work hours: ... Monday - Friday; 8:00a-5:00p Texas Health Presbyterian Hospital Dallas has advanced health ...neurosciences, women's services, and emergency medicine. Our hospital is home to a renowned Level III Neonatal Intensive Care… more