- Molina Healthcare (Fort Worth, TX)
- …ensure appropriate reimbursement to providers. + Resolves escalated complaints regarding utilization management and long-term services and supports (LTSS) ... modification of payment decisions. + Serves as a clinical resource for utilization management , CMOs, physicians and member/provider inquiries/appeals. + Provides… more
- Molina Healthcare (Fort Worth, TX)
- …and cost-effective member care. We are seeking candidates with a RN licensure, Utilization Management knowledge and Medicare Appeals is strongly preferred. Work ... with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At… more
- Texas A&M University System (Fort Worth, TX)
- …of related clinical experience in obstetrics as an Advanced Practice Registered Nurse , including experience in managing and collaborating on high-risk pregnancies in ... APRN license in the State of Texas + Board Certification as a Certified Nurse Midwife (CNM), Women's Health Care Nurse Practitioner (WHNP-BC (TM) ), or… more
- IQVIA (Dallas, TX)
- …+ Four-year College Degree required + Minimum 1 to 3 years Remote / Virtual engagement experience, B2B territory management /account management ... the fluctuating business needs + Private, quiet, dedicated workspace required + Management of Remote / Virtual engagement teams including quality, compliance,… more
- Molina Healthcare (Fort Worth, TX)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... For this position we are seeking a (RN) Registered Nurse who must hold a compact license. This is...who must hold a compact license. This is a Remote position, home office with internet connectivity of high… more
- Molina Healthcare (Fort Worth, TX)
- …with multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. Required Qualifications * At ... (Saturday, Sunday (either one or both)) This is a Remote position, home office with internet connectivity of high...equivalent combination of relevant education and experience. * Registered Nurse (RN). License must be active and unrestricted in… more