- CVS Health (Austin, TX)
- …specialty medication prior authorization (PA) requests reviewed by the Aetna Specialty Medical Prior Authorization department. Reporting to the Pharmacy ... is necessary and will involve computer system data entry, data management , and reporting. + Review criteria-based prior authorizations following policy and… more
- CVS Health (Austin, TX)
- …med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central time zones ... and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and...our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company… more
- Molina Healthcare (Houston, TX)
- …, Group/IPA practice, capitation, HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk ... **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical...resource management . + Develops and implements a Utilization Management program and action plan, which… more
- The Cigna Group (Austin, TX)
- …with the Program Management Senior Manager, Clinical Program Managers, and specialty pharmacy operational team and Medical Economics. + Reviews multiple ... analytical thinker who is responsible for the focus of supporting medical specialty pharmacy redirection savings research, calculation, monitoring, and… more
- Houston Methodist (Houston, TX)
- …+ Professional and technical competence in the critical selection, evaluation, and utilization of the pharmaceutical, medical , and scientific literature + ... At Houston Methodist, the Director Specialty Pharmacy position is responsible for providing strategic...the effective and efficient completion of objectives. + Oversees management of and ensures development for staff to meet… more
- Grifols Shared Services North America, Inc (Houston, TX)
- …110 countries and regions. **Overview:** The primary responsibility of the Bleeding Management Hospital Specialty Sales Representative (HSSR) is to represent key ... products within the Bleeding Management product portfolio with a primary responsibility for the...protocol changes within their related area of practice. + Utilization of corporate resources including Key Account Manager, Managed… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Clinic Specialty Registered Nurse (RN) position is responsible for functioning as an advanced clinician at the Proficient level according ... to Benner's model of clinical practice. The Clinic Specialty RN position provides, and coordinates defined specialty care and associated services to a defined… more
- Sumitomo Pharma (San Antonio, TX)
- …motivated, and experienced individual for the position of **Territory Sales Manager - Specialty .** As our Territory Sales Manager - Specialty , you will have ... of the evolving healthcare landscape, thoughtful planning, purposeful action, and utilization of your available resources in a compliant manner. + Assess… more
- UTMB Health (Friendswood, TX)
- …liability. + Educates the Medical Staff and Nursing Staff on the Utilization Review/Case Management program and provides specific information related to case ... of new personnel and completes a formal preceptor plan in accordance with Utilization Management Policy 09.04. + Identifies and facilitates quality improvement… more
- Evolent (Austin, TX)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Medical Director, MSK Surgery you will be a specialty match reviewer for Spine Surgery cases. you will...cases. you will be a key member of the utilization management team. We can offer you… more