- 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
- Elevance Health (Grand Prairie, TX)
- **Nurse Case Manager II** **Location** : This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... complete the assessment within 48 hours of receipt and meet the criteria._** The **Nurse Case Manager II** is responsible for care management within the scope of… more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- AdventHealth (Mansfield, TX)
- …7:00am-5:30pm)** Flexibility with schedule specific schedule to be discussed with the manager . **Location:** 2300 Lone Star Road; Mansfield, TX 76063 **The community ... career with AdventHealth, named in 2018 by Beckers Hospital Review as one of the 150 Top Places to...community. **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs,… more
- AdventHealth (Mansfield, TX)
- …performance with oversight to assure capital and fiscal accountability. + Partners with Utilization Management for the Utilization Review Committee as well ... career with AdventHealth, named in 2018 by Beckers Hospital Review as one of the 150 Top Places to...closely with physicians and the campus leadership team on utilization / case management issues. Actively participates in outstanding… 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
- Elevance Health (Grand Prairie, TX)
- …program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs. **How you will make an ... the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review , drug monographs, and formulary recommendations. + Develop strategies to… more