• Utilization Review Case

    Dallas Behavioral Healthcare Hospital (Desoto, TX)
    The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
    Dallas Behavioral Healthcare Hospital (03/14/25)
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  • Trainer - Clinical Services - Utilization

    Molina Healthcare (Fort Worth, TX)
    …(RN) or State Clinical Social Worker/Counseling (or related field) License Certified Case Manager (CCM), Utilization Management Certification (CPHM), ... Responsible for the development, implementation, and delivery of training curriculum for Utilization Management, Case Management, and LTSS staff. Leads and… more
    Molina Healthcare (05/07/25)
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  • Pharmacist, Utilization Mgmt (CA & WA)

    Molina Healthcare (Fort Worth, TX)
    …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
    Molina Healthcare (05/02/25)
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  • Registered Nurse Case Manager PRN

    HCA Healthcare (Dallas, TX)
    …step in your career path, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We review all applications. Qualified candidates will ... you have the career opportunities as a Registered Nurse Case Manager PRN you want in your...supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +… more
    HCA Healthcare (04/17/25)
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  • Area Loss Prevention Manager (ALPM)…

    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
    Ross Stores, Inc. (05/08/25)
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  • Behavioral Health Care Manager II

    Elevance Health (Grand Prairie, TX)
    …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... to improve the delivery of care._ **Behavioral Health Care Manager II** **Location:** This is a remote, work from...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses… more
    Elevance Health (04/17/25)
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  • Maintenance Process Excellence Manager

    GAF (Fort Worth, TX)
    …this roof, we protect what matters most. **Team Summary** The Maintenance Excellence Manager is a key member of the Corporate Reliability & Maintenance team and ... with the site Planners/Schedulers/Supervisors and can tailor site-specific needs on a case -by- case basis. + Works with supporting organizations on a unified… more
    GAF (03/16/25)
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  • CBO Project Manager

    Methodist Health System (Dallas, TX)
    …Day (United States of America) **Job Description :** The CBO Project Manager of Performance Improvement (PMPI) is responsible for measuring performance goals, ... role will assist in measuring CBO quality and productivity and proactively review trends and variances that delay reimbursement. This position will support strategic… more
    Methodist Health System (03/04/25)
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  • Manager , HCS Operations Support

    Molina Healthcare (Fort Worth, TX)
    …that support one or more of the following activities: care review / utilization management (prior authorizations, inpatient/outpatient medical necessity, etc.), ... of care and quality of Molina services provided. * Functions as hands-on manager responsible for supervision and coordination of daily activities. * Ensures adequate… more
    Molina Healthcare (05/02/25)
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  • Construction Estimating Manager , AMER…

    Amazon (Dallas, TX)
    …leading examples of innovation in the areas of security, safety, space utilization , efficiency, and cost effectiveness. We are the global team responsible for ... known for changing the face of cloud computing. As a Construction Estimating Manager , you will be responsible for developing and maintaining the cost database, while… more
    Amazon (03/05/25)
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  • Cloud Economics - Program Director Business…

    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
    IBM (04/29/25)
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  • Associate Medical Director - Orthopedic Surgery

    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
    Elevance Health (05/01/25)
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  • Medical Authorization Splst

    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
    Methodist Health System (04/11/25)
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  • Delegation Oversight Nurse Remote based in CA…

    Molina Healthcare (Fort Worth, TX)
    …Licensed Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable ... Certified Clinical Coder + Certified Medical Audit Specialists (CMAS) + Certified Case Manager (CCM) + Certified Professional Healthcare Management (CPHM)… more
    Molina Healthcare (04/11/25)
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  • Home Health-RN-PRN Weekends Only

    Home Care Providers of Texas (Desoto, 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 (04/25/25)
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  • Home Health-RN-PRN-Weekends

    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 (04/25/25)
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  • Home Health RN Full time -South

    Home Care Providers of Texas (Dallas, 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 (05/08/25)
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