- Texas Health Resources (Arlington, TX)
- Director Utilization Management - Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking ... leader for system services for wholly owned and Partner hospitals for utilization management . Job Duties OPERATIONS: Plans, organizes and delegates activities… more
- 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
- 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
- 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
- CenterWell (Fort Worth, TX)
- …to adapt responsibilities as needed and demands a unique blend of clinical management , financial/business acumen, and strategic partnership to optimize patient ... and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader...clinical leader of our primary care team, combining clinical practice with leadership and operational management … more
- CenterWell (Arlington, TX)
- …to adapt responsibilities as needed and demands a unique blend of clinical management , financial/business acumen, and strategic partnership to optimize patient ... and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader...clinical leader of our primary care team, combining clinical practice with leadership and operational management … 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
- 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)
- ** 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)
- …experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... medical policy/procedure development, and provider contracting experience + Current clinical knowledge + Experience demonstrating strong management and… more
- Molina Healthcare (Fort Worth, TX)
- …with knowledge of foundational Health Insurance Operations; particularly Utilization Management , Care Management , and Clinical Operations + Ability ... Supports the maintenance of IT Project accounting in project management tools. Works with Program Director on...operations + Knowledge of Health Insurance Utilization Management , Care Management , and Clinical … 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
- 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