- CVS Health (TX)
- …Monday-Friday standard business hours. No nights, weekends or holidays. As a **UM Clinician Behavioral Health** you will: - Utilize clinical experience and ... and external constituents in the coordination and administration of the utilization /benefit management function. **Required Qualifications** - Valid unrestricted… more
- Elevance Health (Corpus Christi, TX)
- …telephonic or face-to-face assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral ... **LTSS Service Coordinator - Clinician ** **Location:** This is a field based position....health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will… more
- Elevance Health (Cleveland, TX)
- …Polk, San Jacinto, Tyler, or Walker Counties. The **LTSS Service Coordinator - RN Clinician ** is responsible for overall management of member's case within the ... or face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral … more
- Molina Healthcare (TX)
- …3-5 years clinical practice with managed care, hospital nursing or utilization management experience. **Preferred License, Certification, Association** Active, ... an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high...unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- Molina Healthcare (Houston, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... with PEGA helpful. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- Molina Healthcare (Houston, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT… more
- CenterWell (Fort Worth, TX)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- CenterWell (Arlington, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... our primary care team, combining clinical practice with leadership and operational management to ensure high-quality patient care and alignment with Value-Based Care… more
- CenterWell (Dallas, TX)
- …and across a matrixed organization. + A passionate advocate for improving clinician and patient experience through population health management . **Required ... is responsible for managing a team of nurses, community health workers, and behavioral health resources who engage high risk/high needs patients using a team-based… more
- HCA Healthcare (Houston, TX)
- …at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical ... projects related to clinical informatics, including: + standardization + utilization + integration + optimization The DCI is responsible for… more