- Scottish Rite for Children (Dallas, TX)
- …committed to giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital ... and other areas as assigned + Serve on the Utilization Review Committee for the Scottish +...+ Minimum 2 years of precertification experience + Certified Case Manager , preferred + 3-5 years of… more
- HCA Healthcare (Dallas, TX)
- …nurses set us apart from any other healthcare provider. We are seeking an RN Case Manager PRN Inpatient Rehab to join our healthcare family. **Benefits** Medical ... passion for patient care. Apply today for our RN Case Manager PRN Inpatient Rehab opportunity. **Job...pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement.… more
- HCA Healthcare (Lewisville, TX)
- …to you, we encourage you to apply for our Registered Nurse Case Manager PRN opening. Our team will promptly review your application. Highly qualified ... their positions. Join our Team as a Registered Nurse Case Manager PRN and access programs to...supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +… more
- CVS Health (Denton, TX)
- …of Members:** + Through the use of care management tools and information/data review , the Case Manager conducts comprehensive evaluation of referred ... clinical writing and communication skills are required. + The Case Manager is responsible for conducting face...barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in… more
- CVS Health (Dallas, TX)
- …Assessment of Members: -Through the use of care management tools and information/data review , the Case Manager conducts comprehensive evaluation of referred ... assessment, clinical writing and communication skills are required. The Case Manager is responsible for conducting face...barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in… more
- HCA Healthcare (Dallas, TX)
- …corporate level. + Lead centralized case management function, including Clinical Case Management, Utilization Review Services, and Clinical Documentation ... educational training and development for the more than 3,000 case manager , RNs, and social workers involved...Lead centralized case management function, including Clinical Case Management, Utilization Review Services,… more
- Ross Stores, Inc. (Dallas, TX)
- …PURPOSE:** **Ross is always looking for qualified talent for our Area Loss Prevention Manager roles across the Nation, to express your interest please apply to this ... for a particular job function\.** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of...etc\.\) and analytics\. + Identify shortage risks through regular review of indicator reports; partner with stores to develop… more
- IBM (Dallas, TX)
- …vended spend Additional KPIs related to Scorecarding/OKRs, Effective Technology Asset Utilization and Project Optima will be identified between the selected ... candidate and their direct Manager . Primary responsibilities for this role include the following:...staging and spare-parts inventory, * Enhancing cloud technology asset utilization , and streamlining internal IBM Cloud processes, such as… more
- Molina Healthcare (Fort Worth, TX)
- …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified… more
- Children's Home Healthcare (Richardson, TX)
- …RN LICENSE* Children's Home Healthcare is now hiring for a Hybrid RN Clinical Supervisor/ Case Manager ! Children's HH is the premier leader in Pediatric Home ... for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional Services. 8.… more
- CenterWell (Arlington, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... precise + Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving...of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and… more
- Elevance Health (Grand Prairie, TX)
- …the medical necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. + Conducts ... + Extensive orthopedic surgery experience preferred. + Experience with utilization management, especially with CMS guidelines preferred. For candidates working… more
- Methodist Health System (Dallas, TX)
- …rendered care. This position routinely works with physicians, clinic support staff, case managers, nurses, insurance utilization management staff, and patients ... that require clinical judgment to the Provider, and/or Billing Manager , when necessary. * Advises Manager of all patient complaints, and asks for assistance if… 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 ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… 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 ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- Home Care Providers of Texas (Fort Worth, TX)
- …progress. Review evaluation with the care team, patient, family members, physician, and case manager as needed. + Performs PRN visits, and available on call ... as required (about every 3-4 weeks). + Other duties as assigned. Requirements: + Geriatric Home Health Experience + Texas Nursing License + Strong organizational and self-management skills + Strong and compassionate customer service skills + Valid driver's… more
- Home Care Providers of Texas (Fort Worth, TX)
- …progress. Review evaluation with the care team, patient, family members, physician, and case manager as needed. + Performs PRN visits, and available on call ... as required (about every 3-4 weeks). + Other duties as assigned. Requirements: + Geriatric Home Health Experience + Texas Nursing License + Strong organizational and self-management skills + Strong and compassionate customer service skills + Valid driver's… more