- Molina Healthcare (Fort Worth, TX)
- …must be active and unrestricted in state of practice. * Deep understanding of clinical operations: utilization management , care management , etc. * ... JOB DESCRIPTION Job Summary Leads and directs a team supporting clinical performance improvement activities. Responsible for continuous improvement and successful… more
- Elevance Health (Grand Prairie, TX)
- …clinical responsibilities means that the medical director is directly involved in Utilization Management and Case Management . + Daily case reviews for ... to clients/ members. The medical director provides clinical expertise in all aspects of utilization ...for case management /complex clinical management . + Peer-to-peer outreach for both utilization … more
- AdventHealth (Mansfield, TX)
- …performance with oversight to assure capital and fiscal accountability. + Partners with Utilization Management for the Utilization Review Committee as well ... supervision and reporting to the Chief Nursing Officer the Director Care Management Women and Childrens develops...above) in addition to 5 years of direct care management / utilization management experience and increasing… more
- HCA Healthcare (Fort Worth, TX)
- …related hospital departments and external agencies to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all ... a part of our team. **Job Summary and Qualifications** The Facility Case Management Director has the overall responsibility for managing and coordinating… more
- Molina Healthcare (Fort Worth, TX)
- … and effective resource management . + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality...analysts to produce tools to report, monitor and improve Utilization Management . + Actively participates in regulatory,… more
- Elevance Health (Grand Prairie, TX)
- …Capabilities and Experiences:** + Child and Adolescent experience preferred. + Utilization Management experience. + Applied Behavior Analysis (ABA) experience. ... **Behavioral Health Medical** ** Director -Psychiatrist** **Appeals** **Location:** This role enables associates to...an entire clinical program and/or independently performs clinical reviews. + Typically has program management … more
- Molina Healthcare (Fort Worth, TX)
- …EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization /Quality Program Management ... Molina's Behavioral Health function provides leadership and guidance for utilization management and case management ...psychiatric diagnoses and treatment * Provides second level BH clinical reviews, BH peer reviews and appeals * Supports… more
- Molina Healthcare (Fort Worth, TX)
- …of health care services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies ... the most appropriate care at the most effective setting. *Evaluates effectiveness of utilization management (UM) practices - actively monitoring for over and… more
- Molina Healthcare (Fort Worth, TX)
- …health oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and ... - working closely with regional medical directors to standardize behavioral health utilization management policies and procedures to improve quality outcomes and… more
- HCA Healthcare (Weatherford, TX)
- …labor management , including position control, scheduling excellence, productivity management , and premium pay utilization . Maintains staffing to ensure ... care in 21 states and the United Kingdom. We are looking for a Director Surgical Services for our Medical City Weatherford team where excellence creates excellence.… more
- Elevance Health (Grand Prairie, TX)
- **Plan Performance Medical Director ** Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... granted as required by law. The **Plan Performance Medical Director ** serves as a lead clinician and oversees the...This role involves managing the overall medical policies and clinical guidelines to ensure appropriate and cost-effective care. The… more
- Elevance Health (Grand Prairie, TX)
- …experience, which would provide an equivalent background. **Preferred Qualifications:** + Utilization management experience preferred. For candidates working in ... **Medical Director Associate - CarelonRx** **Location:** This role enables...locations may be considered. CarelonRx delivers market-leading pharmacy benefit management and medication dispensing services to drive affordability and… more
- Elevance Health (Grand Prairie, TX)
- ** Clinical Operations Associate Medical Director ** **Carelon Medical Benefits Management ** **Radiology Benefit Management / Utilization Review** ... granted as required by law._ The ** Clinical Operations Associate Medical Director ** is responsible for supporting the medical management staff ensuring… more
- Molina Healthcare (Fort Worth, TX)
- …and cost-effective member care. **Job Duties** + Performs Behavioral Health utilization management reviews for inpatient, outpatient, and intermediate-level ... Nurse and/or Nurse Practitioner, ideally in managed care, behavioral health, or utilization management . + Demonstrated experience in the application of medical… more
- AdventHealth (Burleson, TX)
- …Responsible and accountable for planning, organizing, coordinating, and evaluating the management and clinical practice activities for the nursing unit(s) ... Education* (Certifications and Degrees without out-of-pocket tuition expense) - Nursing Clinical Ladder Program* **Our promise to you:** Joining Texas Health Huguley… more
- AdventHealth (Burleson, TX)
- …Nurse Manager is a specialized health care professional who reports to the department Director and collaborates with the Director and other leaders to provide ... of selected patient populations across the continuum of illness; promoting effective utilization of and monitors health care resources; and assumes a leadership role… more
- Elevance Health (Grand Prairie, TX)
- …in process improvement initiatives to improve the efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and ... a medical necessity denial determination made by a Medical Director . + Develops and fosters ongoing relationships with physicians,...equivalent. + Requires a minimum of 6 years of clinical experience and/or utilization review experience. +… more
- Texas Health Resources (Fort Worth, TX)
- …patient flow, patient care and assignments. Responsible for assisting the manager/ director with human resource management to include evaluations, coaching, ... Nursing Preferred Experience * 2 Years experience as a clinical nurse with previous experience as a charge nurse...staff. * Participates in progressive disciplinary action process with Manager/ Director and staff. * Uses Performance Management … more
- HCA Healthcare (Fort Worth, TX)
- …**Job Summary and Qualifications** Under the general supervision of the unit's Director the Nurse Manager of NICU is responsible for the efficient, effective ... assigned units. This includes, but is not limited to management of the budget, provision of patient care services,...a sound knowledge base in nursing practice and its clinical application to the patient population served in the… more
- AdventHealth (Mansfield, TX)
- …Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general ... supervision of the Care Managment Supervisor or Manager or Director of Nursing and is responsible for patient evaluations of post-hospital needs; development of a… more