- HCA Healthcare (Dallas, TX)
- …participates in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement improvements ... design, collection, and reporting of adverse drug reactions, drug utilization reviews, medication errors and pharmacy quality initiatives +...Acts as manager in charge as assigned. + Provides review and guidance on physician order sets and other… more
- Toyota (Plano, TX)
- …Utilizing reporting, trackers, and systems, the Dealer Lending Portfolio Analyst will review metrics such as line utilization , audit results, financial ... performance, assessing financial performance, confirming Covenant compliance, and monitoring line utilization trends. + Act as a point of contact both internally… more
- ManpowerGroup (Plano, TX)
- …required; AA degree is a plus. + Minimum of 2+ years experience in a utilization review environment or similar work experience. + Knowledge of private insurance, ... Workers Compensation, and Medicare guidelines related to utilization review . + Proficient with Microsoft Office (Word & Excel); experience with medical billing… more
- Molina Healthcare (San Antonio, TX)
- …rate tracking and supplemental data impact reporting. + Develop Medical Record Review project reporting to track progress and team productivity reporting. + ... and other statistical methodologies to predict future trends in cost, utilization , and performance. + Assist with research, development and completion of… more
- HCA Healthcare (San Antonio, TX)
- …and actively participating in daily multidisciplinary and bedside rounds, completing drug utilization review to promote rational drug therapy, leading and ... to promote rational drug therapy and make improvements identified by drug utilization evaluations. + You will provide accurate and timely medication information to… more
- Elevance Health (Grand Prairie, TX)
- …or equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. + Current active, valid and unrestricted RN license ... improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and applies… 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
- Elevance Health (Houston, 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 ... appeal case reviews with attending physicians or other ordering providers to discuss review determinations. + Serves as a resource and consultant to other areas of… more
- Elevance Health (Grand Prairie, TX)
- …program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs. **How you will make an ... the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review , drug monographs, and formulary recommendations. + Develop strategies to… more
- Molina Healthcare (TX)
- …analysts on software applications, business domain and design standards. *Conducts peer review of other analysts (internal and contract staff) to ensure standards ... Years of experience in Analysis related to HEDIS rate tracking, Medical Record Review tracking, Interventions tracking for at least one line of business among… more