- Parexel (Austin, TX)
- …Data Management Lead to join our team. If you have a passion for clinical research, strong project management skills, and a knack for data management , ... Science, OR equivalent industry experience. + 7+ years experience in pharmaceutical/biotech clinical data management / Biometrics ( clinical trial data… more
- Humana (Austin, TX)
- …of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... holiday per calendar year** **Job Description:** The Staff Utilization Management Pharmacist is a clinical professional responsible for conducting… more
- Evolent (Austin, TX)
- …a Clinical Reviewer, Nurse, you will routinely interact with leadership and management staff , other CR's ( Clinical Reviewers), providers, office staff ... Nurse, you will be a key member of the utilization management team. We can offer you...standards in the participating provider network and for other clinical staff . + Converses with medical office… more
- Molina Healthcare (Austin, TX)
- …actions. + Performs audits in utilization management , care management , member assessment, behavioral health, and/or other clinical teams, and monitors ... perspective to ensure member needs are being met.* Assesses clinical staff regarding appropriate clinical ...care experience, with at least 1 year experience in utilization management , care management , and/or… more
- CenterWell (Austin, TX)
- …for review of the appropriate number of Case Managers and clinical staff documentation to include starts-of-care, resumption-of-cares, and re-certifications, ... documentation in addition to feedback and recommendations by Utilization Review staff . Upon completion of the...systems and process. Competently performs patient care assignments and staff management activities. + Provides direct patient… more
- Molina Healthcare (Austin, TX)
- …Active, unrestricted State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in Health Care ... management initiatives and analytical studies aimed at optimizing utilization of medical resources and maximizing operational efficiencies. + Engages with… more
- HCA Healthcare (Austin, TX)
- …integration of services throughout the system is an expectation. Collaborates with other management staff , supervisors, clinical staff , and ... for staff performing duties in multiple physical locations. Works with clinical , management , and other support personnel to coordinate both on and… more
- HCA Healthcare (Austin, TX)
- …Pharmacy Manager is responsible for designing, implementing and managing the pharmacy clinical programs. This includes formulary management , policy and procedure ... ready to manage in a new era as a Clinical Pharmacy Manager where building a healthier tomorrow is...to practitioners. Suggest appropriate, cost-effective therapeutic alternatives to medical staff as needed. + You will develop, guide, and… more
- Cardinal Health (Austin, TX)
- **Ideal candidate will live near a major/regional airport.** **_What Clinical Operations contributes to Cardinal Health_** Clinical Operations is responsible for ... and service education to facilitate technology adoption and workflow change management . + Demonstrates extensive knowledge and understanding of relevant clinical… more
- AccentCare, Inc. (Austin, TX)
- …(EMR) preferred. Responsibilities: + Daily completion of the following tasks: daily management of KPIs, field staff support, verbal orders, workflow, ... etc. + Reporting and management of case management model with focus on paraprofessional utilization ... - including correct visit types selected, continuity of clinical team, capacity management , etc. + Maintain… more
- Evolent (Austin, TX)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks ... independent nursing judgement and decision-making, physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse… more
- Evolent (Austin, TX)
- … Reviewer, Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
- Molina Healthcare (Austin, TX)
- JOB DESCRIPTION Job SummaryProvides support for pharmacy Medication Therapy Management (MTM) activities. Contributes to overarching pharmacy strategy to ensure ... in the development/administration of pharmacy programs designed to enhance the utilization of targeted drugs and identification of cost-saving pharmacy practices. *… more
- HCA Healthcare (Austin, TX)
- …programs to facility medical staff regarding clinical resource management , appropriate documents standards, utilization and quality issues, and quality ... , and utilization review/ management . + Consults with facility-level staff regarding delegated utilization management and disease management… more
- Molina Healthcare (Austin, TX)
- …national, state, and local laws and regulatory requirements affecting the medical and clinical staff . + Marketplace UM reviews + MD licenses required for ... resource management . + Develops and implements a Utilization Management program and action plan, which...clinical lead, the medical director, and quality improvement staff . + Facilitates conformance to Medicare, Medicaid, NCQA and… more
- Highmark Health (Austin, TX)
- …per week (Tuesday-Thursday).** This role supports the full application product lifecycle for ** clinical and utilization management software** , with a ... and technical teams. They function as a pivotal bridge, translating high-level ** clinical and utilization management software** business needs into… more
- Evolent (Austin, TX)
- …Cardiologist)** Are you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical ... appropriate, high-value care aligned with clinical guidelines. + Collaborate with leadership, management , and clinical staff to address complex cases and… more
- Molina Healthcare (Austin, 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
- CVS Health (Austin, TX)
- …intake and outgoing calls for medical services. We work closely with both case management team and utilization management team. The Care Management ... it all with heart, each and every day. **Position Summary** The Care Management Associate (CMA) supports comprehensive coordination of medical services that include… more
- Evolent (Austin, TX)
- …Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… more
