- Baylor Scott & White Health (Dallas, TX)
- …+ Experience working with Substance use treatment experience and/or behavioral health treatment + Experience with Utilization Management for Substance use ... vary based on position type and/or level **Job Summary** Utilization Review Specialist conducts reviews and shares...quality. **Essential Functions of the Role** + Process all Behavioral Health and Substance Use Disorder authorizations… more
- Molina Healthcare (Dallas, TX)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Dallas, TX)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Dallas, TX)
- …plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / MCG… more
- Molina Healthcare (Dallas, TX)
- …facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need ... or ER unit. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). To all current Molina employees: If… more
- CVS Health (Plano, TX)
- …judgment and critical thinking skills in order to facilitate appropriate physical, behavioral health , psychosocial wrap around services. + The care manager ... and company policies and procedures. Required Qualifications: + 2+ years of experience in behavioral health or social services required + A minimum of a… more
- Elevance Health (Grand Prairie, TX)
- …required. **Preferred skills, capabilities, and experiences:** + Behavioral health background preferred + Familiarity with Utilization Management Guidelines, ... on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with… more
- Texas Health Resources (Plano, TX)
- …cardiology, neurosurgery and spine care, orthopedics, women's services, adult and adolescent behavioral health , and critical care. Our hospital also provides ... for qualified candidates like you to join our Texas Health family._ + Work location: Texas Health ...this purpose. Provide resources and guidance to support the utilization of evidence based practice standards. Identify and utilize… more
- Texas Health Resources (Bedford, TX)
- …and vascular care, acute and medical-surgical care, intermediate/step-down care, oncology, behavioral health , and emergency medicine. Additional services include ... for qualified candidates like you to join our Texas Health family._ Work location: Texas Health Harris...this purpose. Provide resources and guidance to support the utilization of evidence based practice standards. Identify and utilize… more
- HCA Healthcare (Dallas, TX)
- …services 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 ... providing ongoing support for corporate/division/facility projects related to the electronic health record (EHR) including: 1. standardization 2. utilization 3.… more
- HCA Healthcare (Dallas, TX)
- …services 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 ... Dallas, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...in daily multidisciplinary and bedside rounds + Completes drug utilization reviews to promote rational drug therapy and implement… more
- Molina Healthcare (Dallas, TX)
- …plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. ... role must complete courses required to obtain licensure in all states. + Utilization Review Lead responsibilities also include but not limited to, collaborate… more
- HCA Healthcare (Fort Worth, TX)
- …services 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 City Fort Worth, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and programs… more
- Prime Healthcare (Mesquite, TX)
- …plans, including referrals to rehab, home health , or long-term care facilities + Utilization Review : m onitor the use of hospital resources and services to ... care transitions. RN Case Managers also conduct discharge planning, utilization review , and helping patients navigate insurance...of the benefits of working at Prime Healthcare: + Health , dental, and vision insurance options + Paid vacation,… more
- Molina Healthcare (Dallas, TX)
- …eligible members as well as Medication Adherence Programs for STAR, HEDIS and behavioral health medications. * Ensures that adequate staffing coverage is present ... manner. These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state… more
- HCA Healthcare (Dallas, TX)
- …services 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 ... Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...HBP services in their respective Division to ensure maximum utilization of pathology resources and the efficient delivery of… more
- HCA Healthcare (Dallas, TX)
- …services 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 ... Office, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until they have strong clinical… more
- HCA Healthcare (Dallas, TX)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical ... Spine, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Fort Worth, TX)
- …services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical ... Alliance offers a total rewards package that supports the health , life, career and retirement of our colleagues. The...the instrument and equipment set-up for your OR, including utilization of preference cards and ability to anticipate your… more
- HCA Healthcare (Sachse, TX)
- …services 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 ... **Benefits** Medical City Sachse, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and… more