- AECOM (Dallas, TX)
- …to I&G Director for annual budgets and business planning, staff utilization , department resource needs (hardware/software needs, strategic investments) and other ... future resource and staff needs to optimize the department staff utilization , including incorporation of value Engineering Centers in project staff planning… more
- Elevance Health (Houston, TX)
- …+ Demonstrate and maintain knowledge of relevant policies and regulations pertaining to utilization review of oncology care. + Participate on committees or in ... and providers. **How you will make an impact:** + Perform physician-level case review , following initial nurse review , of Medical Oncology regimens and… more
- Elevance Health (Grand Prairie, TX)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... law._ The **Pharmacist Clinical** is responsible for managing the selection and utilization of pharmaceuticals and supports core clinical programs such as DUR, DIS… more
- Houston Methodist (Houston, TX)
- …patient satisfaction and safety measures. **FINANCE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use, ... benefits for patients and reimbursement for the hospital. + Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource … more
- Austin Industries (Irving, TX)
- …**Texas area.** The Equipment Service Manager is responsible for maximizing the utilization of Austin Bridge and Road's equipment across the project spectrum. ... equipment platform and refine and develop and implement new Infrastructure based utilization and management program + Participate in the development of capture plans… more
- Schwan's Company (Pasadena, TX)
- …costing specifications and system data. + Manage the effective utilization of employees' skills, development, quality, housekeeping, safety, utilization ... ways to reduce, waste downtime and improve equipment and employee utilization in our continuous efforts to improve processes utilized; presents proposals… more
- Royal Vopak (Deer Park, TX)
- …is a big plus + Good knowledge and experience of cost estimating software utilization + Good knowledge and experience of CAD software utilization + Expert ... project owner identifying project technical staffing requirements to support projects + Review and validate Project Management plans + Initiate and organize key… more
- Highmark Health (Austin, TX)
- …of the claim rejection and the proper action to complete the retrospective claim review with the goal of proper and timely payment to provider and member ... Payment Integrity strategies on a pre-payment and retrospective claims review basis. Review process includes a ...data to assure appropriate level of payment and resource utilization . It is also used to identify issues which… more
- Oracle (Austin, TX)
- …stays. + Knowledge of third-party payor rules and regulations. + 2-3 years of Utilization Review experience in a healthcare setting preferred; 1-2 years of ... college and AHIMA Certified RHIT credentials preferred + Certification in Utilization Review , case management, and healthcare quality preferred… more
- Highmark Health (Austin, TX)
- …NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the ... **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most… more