- Molina Healthcare (Austin, 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
- CVS Health (Austin, TX)
- …of healthcare resources. Applies clinical expertise and knowledge of utilization management principles to influence stakeholders and networks of healthcare ... expertise to enhance their understanding of utilization management principles and improve their clinical decision-making.... clinical setting with diverse cultural dynamics of clinical staff and patients. Registered Nurse (RN)… 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
- J&J Family of Companies (Austin, TX)
- …beyond the EP/IC lab, including, but not limited to physicians, nurses and technicians, clinical and hospital administrators and staff . + Stay current on company ... Description:** We are searching for the best talent for **Senior Ultrasound Clinical Account Specialist** to be in **Austin, TX** and surrounding metro. **About… 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
- Humana (Austin, TX)
- …corporate communications to be shared with senior leadership. + Supports trend management by conducting analysis of drug spend, utilization , and/or approval ... communicating with staff in different positions and all levels of management positions + Manages the Humana Michigan FIDE-SNP health plan relationship with our… 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
- 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
- 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
- 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
- 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
- Evolent (Austin, TX)
- …As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... better health outcomes. **Collaboration Opportunities:** + Routinely interacts with leadership and management staff , other Physicians, and staff whenever a… 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 Field Medical Director, Oncology, 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
