- CenterWell (Austin, TX)
- …healthcare industry. The UM Administration Coordinator - Phone Intake contributes to administration of utilization management . The UM Administration ... works on semi-routine assignments. Shift Hours - 8a - 5 The UM Administration Coordinator - Phone Intake provides non-clinical support for the policies and… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …will be responsible for establishing imaging protocols; reviewing imaging requests; utilization management ; ensuring appropriate preps and medication are ... mammographer and will have responsibilities in other areas such as program administration . The physician must demonstrate the knowledge and skills necessary to… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …will be responsible for establishing imaging protocols; reviewing imaging requests; utilization management ; ensuring appropriate preps and medication are ... Timely completion of documentation and upkeep of credentials. (3) Staff Management : Participate in the FPPE/OPPE process. Adheres to employee health requirements.… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …of the new focus on the Medical Home and Patient Centric Care, Utilization Management , and Patient Safety initiatives, and process improvements (system ... of credentials required for privileging and re-privileging. 3. Staff Management : Participate in the FPPE/OPPE process. Adheres to employee...the promotion of health, prevention of illness, treatment of disease , and care at the end of life. 2.… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …and upkeep of credentials required for privileging and re-privileging. Staff Management : Participates in the FPPE/OPPE process. Adheres to employee health ... Participates in Clinical Pertinence Reviews (routine medical record reviews). Time/Leave Management : Adheres to Tour of Duties, timely requests for leave in… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …upkeep of credentials required for privileging and re-privileging. Staff Management : Participate in the Focused Professional Practice Evaluation (FPPE)/Ongoing ... Participate in Clinical Pertinence Reviews (routine medical record reviews). Time/Leave Management : Adherence to tour of duties, timely requests for leave in… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …and effective for the promotion of health, prevention of illness, treatment of disease , and care at the end of life. Practitioners are expected to provide ... upkeep of credentials required for privileging and re-privileging. Staff Management : Participate in the Focused Professional Practice Evaluations (FPPE)/Ongoing… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …Living Centers, Home Based Primary Care, Hospital In Home, Geriatric Evaluation Management (GEM) clinic and Palliative/Hospice care service as assigned. The medical ... lab/diagnostic test result notifications in a timely manner. - Clinical Management including direct and indirect patient care: ensure all required encounters… more
- Veterans Affairs, Veterans Health Administration (Amarillo, TX)
- …through the continuum of care, patient and family education, patient self- management and supporting factors that impact customer satisfaction. Duties of the ... and demonstrates understanding of the long sheet and importance of daily utilization of the form; Working knowledge of shower/tub room processes. Understands… more
- Molina Healthcare (Austin, TX)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, disease management ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and...resource management . + Develops and implements a Utilization Management program and action plan, which… more
- Molina Healthcare (Austin, TX)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment, disease management ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and...resource management . + Develops and implements a Utilization Management program and action plan, which… more
- HCA Healthcare (El Paso, TX)
- … review/ management + You will consult with facility-level staff regarding delegated utilization management and disease management operations under ... ongoing in-service programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues,… more
- Evolent (Austin, TX)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... the Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Novo Nordisk (Huntsville, TX)
- …its associated risks + Effectively present the Standards of Care for cardiovascular disease , highlighting the management of cardiovascular risk in patients with ... a diverse range of HCPs and local stakeholders to enhance cardiometabolic management across the territory and region. Additionally, the role involves proactive… more
- CenterWell (Dallas, TX)
- …providing medical guidance and expertise. + Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the ... Responsible for medical interpretation, reviews, and decisions as required for plan administration . + Monitor medical performance and provide guidance to ensure that… more
- Molina Healthcare (Fort Worth, TX)
- …clinical systems analysis, or equivalent experience * 2 or more years in case, disease , or utilization management ; managed care; or medical/behavioral health ... development, implementation, and collaboration with the delivery of training curriculum for Utilization Management , Case Management , and LTSS staff. **Job… more
- CVS Health (Austin, TX)
- …Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible ... interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing… more
- CVS Health (Austin, TX)
- …Aetna/CVS Health. Founded in 1993, AHH is URAC accredited in Case Management , Disease Management and Utilization Management . AHH delivers flexible ... interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing… more
- Highmark Health (Austin, TX)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... participates as the physician member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- UTMB Health (Angleton, TX)
- …/ nurses, and the nursing aspects for specialty quality standards (eg critical care, disease management , etc.). **Financial Management ** + Works closely with ... valid temporary permit to practice in Texas. . Certification in nursing administration or nursing specialty. **Job Summary:** The administrator and Associate Chief… more