- Dallas Behavioral Healthcare Hospital (Desoto, TX)
- The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and ... help patients access the full range of their benefits through the utilization review process. + Conducts admission reviews. + Conducts concurrent and extended… more
- Texas Health Resources (Arlington, TX)
- …professional nursing in the state of Texas required upon hire ACM - Accredited Case Manager or CCM, CPHM or Milliman certification preferred upon hire Skills ... Director Utilization Management-Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for… more
- Molina Healthcare (Fort Worth, TX)
- …(such as, reviewing prior authorization requirements, reviewing drug/provider utilization patterns and pharmacy costs management), clinical pharmacy services ... (such as, therapeutic drug monitoring, drug regimen review , patient education, and medical staff interaction), and oversight (establishing and measuring performance… more
- Texas Health Resources (Dallas, TX)
- Case Manager - Inpatient Rehabilitation _Bring your passion to Texas Health So We Are Better + Together_ **Work location:** Texas Health Dallas, 8200 Walnut Hill ... Management 12 Months Req or ACM - Accredited Case Manager upon hire if LBSW/LMSW 12...resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective… more
- 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 (Fort Worth, 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 (Arlington, 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
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **$3000 Sign-On Bonus** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more
- Molina Healthcare (Fort Worth, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... ASSOCIATION:** Certified Clinical Coder, Certified Medical Audit Specialists, Certified Case Manager , Certified Professional Healthcare Management, Certified… more
- 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. (Dallas, TX)
- …and development for our teams\. **GENERAL PURPOSE:** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of Ross Stores, Inc\. ... Operations, MPT, etc\.\) and analytics\. * Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to… more
- Veterans Affairs, Veterans Health Administration (Duncanville, TX)
- …and from the community. Possesses the knowledge related to VHA guidelines, utilization review criteria, current evidence-based standards of care, compliance ... Summary The Registered Nurse - Nurse Manager - Community Home Care position is with...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
- CBRE (Dallas, TX)
- Sr Project Manager - Dallas Job ID 244110 Posted 21-Oct-2025 Service line PJM Segment Role type Full-time Areas of Interest Project Management Location(s) Dallas - ... - United States of America CBRE/Turner & Townsand is seeking a Senior Project Manager to lead construction projects for a major client in Texas. These projects are… more
- Elevance Health (Grand Prairie, TX)
- …to clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management. Provides input on the ... means that the medical director is directly involved in Utilization Management and Case Management. + Daily...state or territory of the United States when conducting utilization review or an appeals consideration and… more
- Molina Healthcare (Fort Worth, TX)
- …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of… more
- Molina Healthcare (Fort Worth, TX)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… more
- HCA Healthcare (Dallas, TX)
- …order for a formal pre-admission assessment for acute inpatient rehab through their assigned case manager . + Once Case Management has completed the Patient ... and off-site review of patients in designated facilities to assist Case Management in identifying patients that could clinically benefit from rehab services. +… more
- CenterWell (Arlington, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... care being provided meets appropriate standards and to ensure cost-effective utilization practices. + Represent CenterWell/Conviva brands in local communities and… more
- 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 ... for clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss … more
- CenterWell (Fort Worth, TX)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... coaching initiatives are precise *Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving clinical excellence… more