- Humana (Austin, TX)
- …and help us put health first** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical necessity ... required. Mandatory overtime during peak season.** **Job Description:** The Staff Utilization Management Pharmacist (VSP/PT)...**Job Description:** The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional… more
- CVS Health (TX)
- …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... expertise to enhance their understanding of utilization management principles and improve their clinical decision-making.... clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse (RN)… more
- Houston Methodist (Katy, TX)
- …Utilization Review department to ensure efficient, high-quality, and compliant utilization management practices across the organization. This position ensures ... as a subject matter expert and front-line leader, guiding clinical and non- clinical staff in...preferred **EXPERIENCE** + Five years' experience in inpatient case management , social work or utilization management… more
- Humana (Austin, TX)
- …part of our caring community and help us put health first** The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional 2 work assignments… more
- Houston Methodist (Katy, TX)
- …is responsible for strategic, administrative, and operational leadership for the Utilization Management (UM) department across the Houston Methodist system. ... on medical necessity and level-of-care criteria. + Oversees the denials management clinical team for concurrent, retrospective, and self-denial processes.… more
- UTMB Health (Webster, TX)
- …activities/projects + Provides assistance regarding clinical issues to non-nursing utilization review staff + Demonstrates support of the department and ... efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions,… more
- Sedgwick (Austin, TX)
- …to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. **ARE YOU AN IDEAL CANDIDATE?** We are ... Work(R) Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator **PRIMARY PURPOSE** : To assign ...+ Enters demographics and UR information into claims or clinical management system; maintains data integrity. +… more
- UTMB Health (Huntsville, TX)
- Clinical Staff Pharmacist - Huntsville Central Pharmacy **Huntsville, Texas, United States** Allied Health UTMB Health Requisition # 2507177 The mission of ... provision of safe, effective, and timely medication therapy through drug utilization review and collaboration with other healthcare professionals. Responsible for… more
- CenterWell (Austin, TX)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
- CenterWell (San Angelo, TX)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
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