- Healthfirst (TX)
- … management, identifying alternative care options, and discharge planning** + **Certified Case Manager ** + **Interqual and//or Milliman knowledge** + **Knowledge ... This position is 100% Remote** **Duties//Responsibilities:** + **Provides case management services for assigned member caseloads which includes:** +… more
- Molina Healthcare (Dallas, TX)
- …medications safety and medication use policies). **KNOWLEDGE/SKILLS/ABILITIES** The Pharmacist, UM will be responsible for reviewing coverage determinations and ... in a timely, compliant, and accurate manner. The Pharmacist, UM will also be responsible for serving as a...changes for the upcoming year. + Works with the Case Management department as part of a member-centered interdisciplinary… more
- Elevance Health (Grand Prairie, TX)
- **JR168679 Behavioral Health Care Manager I** The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health ... necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as… more
- Elevance Health (Grand Prairie, TX)
- …necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract. + Refers cases to Peer Reviewers as ... and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to… more