• Medical Director - Behavioral Health

    CVS Health (Austin, TX)
    …Qualifications** * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. **Education** * Active ... program/operational efficiency involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the… more
    CVS Health (07/03/25)
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  • Utilization Review Specialist RN…

    Houston Methodist (Sugar Land, TX)
    At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...process improvements). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care… more
    Houston Methodist (07/29/25)
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  • Utilization Review Nurse…

    Houston Methodist (Houston, TX)
    At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... determinations + Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare, Medicaid, and Managed… more
    Houston Methodist (07/25/25)
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  • Lead Utilization Management Coordinator-…

    Houston Behavioral Healthcare Hospital (Houston, TX)
    …The Lead Utilization Management Coordinator will report to the Director of Utilization Review and will be responsible to provide quality case management ... with others. Takes responsibility for own action. + Coordinates with physician individualized discharge planning for patients. + Documents services provided to… more
    Houston Behavioral Healthcare Hospital (08/09/25)
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  • Physician Advisor

    Houston Methodist (The Woodlands, TX)
    …resources. This position is a key member and leader of the hospital's utilization review /management committee, which is charged with regulatory goals of ensuring ... of care, length of stay, and quality issues. + Chair the utilization review /management committee, actively participates in defining operational strategic… more
    Houston Methodist (07/05/25)
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  • Physician Advisor

    CommonSpirit Health (Houston, TX)
    …position and you must be licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred ... objectives for providing quality patient care, to assure effective and efficient utilization of health care services. The PA communicates remotely with case and… more
    CommonSpirit Health (06/28/25)
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  • Insurance Verification Specialist 2

    Baylor Scott & White Health (Plano, TX)
    …needs. + Calculates accurate patient financial responsibility. + Communicates promptly with Utilization Review . Collaborates with the physician and staff ... to ensure financial clearance before the patient's service. + Interprets complex payer coverage information, including network participation status, limited plan coverage, and inactive benefits. + Assists co-workers and facility customers with complex… more
    Baylor Scott & White Health (07/18/25)
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  • Physician , Radiologist/Mammographer…

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities This is an OPEN CONTINUOUS ANNOUNCEMENT ... will be referred at regular intervals or as additional vacancies occur. The physician will serve as a clinical diagnostic radiologist and mammographer. The incumbent… more
    Veterans Affairs, Veterans Health Administration (07/31/25)
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  • Staff Physician (Primary Care - Spinal Cord…

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    Summary The Staff Physician , Spinal Cord Injury/Disorders Service (SCI/D) is responsible for patient care, patient/family education, and supervision of resident ... to maintain proficiency in state-of-the-art rehabilitation/medical care. Responsibilities Staff Physician (SCI/D) is responsible for patient care, patient/family education.… more
    Veterans Affairs, Veterans Health Administration (08/08/25)
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  • Physician - Geriatrics Hospital In Home…

    Veterans Affairs, Veterans Health Administration (San Antonio, TX)
    …determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Responsibilities The Geriatric and Extended Care Medical ... plan, put in practice medical care advances and practice standards. - Arranging physician coverage and communicating the plan of coverage to the team members when… more
    Veterans Affairs, Veterans Health Administration (07/31/25)
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