• Case Manager and Utilization

    Scottish Rite for Children (Dallas, TX)
    …committed to giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital ... and other areas as assigned + Serve on the Utilization Review Committee for the Scottish +...+ Minimum 2 years of precertification experience + Certified Case Manager , preferred + 3-5 years of… more
    Scottish Rite for Children (05/23/25)
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  • RN Case Manager PRN Inpatient Rehab

    HCA Healthcare (Dallas, TX)
    …nurses set us apart from any other healthcare provider. We are seeking an RN Case Manager PRN Inpatient Rehab to join our healthcare family. **Benefits** Medical ... passion for patient care. Apply today for our RN Case Manager PRN Inpatient Rehab opportunity. **Job...pertaining to federally funded programs as they relate to utilization review , discharge planning and financial reimbursement.… more
    HCA Healthcare (05/17/25)
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  • Registered Nurse Case Manager PRN

    HCA Healthcare (Lewisville, TX)
    …to you, we encourage you to apply for our Registered Nurse Case Manager PRN opening. Our team will promptly review your application. Highly qualified ... their positions. Join our Team as a Registered Nurse Case Manager PRN and access programs to...supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +… more
    HCA Healthcare (05/23/25)
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  • Registered Nurse Case Manager

    HCA Healthcare (Fort Worth, TX)
    …step in your career path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... you have the career opportunities as a Registered Nurse Case Manager you want in your current...supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +… more
    HCA Healthcare (06/03/25)
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  • Analyst, Case Management - Field

    CVS Health (Dallas, TX)
    …of Members:** + Through the use of care management tools and information/data review , the Case Manager conducts comprehensive evaluation of referred ... clinical writing and communication skills are required. + The Case Manager is responsible for conducting face...barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in… more
    CVS Health (05/24/25)
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  • Case Management Analyst - Field - Dallas,…

    CVS Health (Dallas, TX)
    …Assessment of Members: -Through the use of care management tools and information/data review , the Case Manager conducts comprehensive evaluation of referred ... assessment, clinical writing and communication skills are required. The Case Manager is responsible for conducting face...barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in… more
    CVS Health (05/10/25)
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  • Assistant General Manager

    ABM Industries (Dallas, TX)
    **Overview** An Assistant General Manager , as the senior member of the General Manager 's Staff, is charged with the responsibility of organizing and directing ... major duties to be performed by each Assistant General Manager . **Benefit Information:** ABM offers a comprehensive benefits package....and the resolution of the problem. + Monitor and review on a daily basis all required logs, for… more
    ABM Industries (06/02/25)
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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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  • 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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  • Clinical Appeals Nurse (RN)

    Molina Healthcare (Fort Worth, TX)
    …Managed Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, ... unrestricted Certified Clinical Coder + Certified Medical Audit Specialist + Certified Case Manager + Certified Professional Healthcare Management + Certified… more
    Molina Healthcare (05/16/25)
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  • Clinical Supervisor RN

    Children's Home Healthcare (Richardson, TX)
    …RN LICENSE* Children's Home Healthcare is now hiring for a Hybrid RN Clinical Supervisor/ Case Manager ! Children's HH is the premier leader in Pediatric Home ... for Home Health services from insurance company. 7. Attend quarterly Utilization Review meetings as designated by the Director of Professional Services. 8.… more
    Children's Home Healthcare (05/13/25)
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  • Associate Medical Director- Dallas

    CenterWell (Arlington, TX)
    …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... precise + Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving...of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and… more
    CenterWell (04/18/25)
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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 Specialist

    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 (05/25/25)
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  • Plan Performance Medical Director- Washington…

    Elevance Health (Grand Prairie, TX)
    …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
    Elevance Health (05/22/25)
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  • Medical Director- Medicare

    Elevance Health (Grand Prairie, TX)
    …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
    Elevance Health (05/20/25)
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