- 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
- Texas Health Resources (Dallas, TX)
- Case Manager - Inpatient Rehabilitation _Bring your passion to Texas Health So We Are Better + Together_ **Work location:** Texas Health Dallas, 8200 Walnut Hill ... Management 12 Months Req or ACM - Accredited Case Manager upon hire if LBSW/LMSW 12...resources. Assesses patient information utilizing psychological and medical knowledge. Utilization Review and Management * Performs effective… more
- HCA Healthcare (Dallas, TX)
- …step in your career path, we encourage you to apply for our Registered Nurse Case Manager PRN opening. We review all applications. Qualified candidates will ... you have the career opportunities as a Registered Nurse Case Manager PRN you want in your...supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +… more
- Texas Health Resources (Arlington, TX)
- …Years Clinical psychiatric or chemical dependency experience Required and * 6 Months in case management or utilization review Required * Prior experience ... Behavioral Health - Case Manager _Bring your passion to...Preferred What You Will Do Daily Payor and Chart Review Activities Identifies those cases requiring certification or re-certification… more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **Sign on Bonus: $2000.** **Location: Virtual: This role enables associates to work virtually full-time, with the exception ... in different states; therefore, Multi-State Licensure will be required.** The **Telephonic Nurse Case Manager II** is responsible for care management within the… more
- Erickson Living (Dallas, TX)
- Location: Highland Springs by Erickson Senior Living Join our team as a RN Case Manager (also known as Care Coordinator, Erickson Advantage at Erickson Senior ... of medical practice; insurance benefit structures and related legal/medical issues; and utilization review and quality assurance procedures. Please note that… more
- Ross Stores, Inc. (Dallas, TX)
- …PURPOSE:** **Ross is always looking for qualified talent for our Area Loss Prevention Manager roles across the Nation, to express your interest please apply to this ... for a particular job function\.** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of...etc\.\) and analytics\. + Identify shortage risks through regular review of indicator reports; partner with stores to develop… more
- Elevance Health (Grand Prairie, TX)
- …services only, and there is licensed staff supervision. + Previous experience in case management/ utilization management with a broad range of experience with ... **Behavioral Health - Care Manager II** **Location:** _Virtual:_ This role enables associate...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact:** + Uses… more
- Ross Stores, Inc. (Dallas, TX)
- …and development for our teams\. **GENERAL PURPOSE:** The Area Loss Prevention Manager \(ALPM\) is responsible for protecting the assets of Ross Stores, Inc\. ... Operations, MPT, etc\.\) and analytics\. * Identify shortage risks through regular review of indicator reports; partner with stores to develop action plans to… more
- Molina Healthcare (Dallas, TX)
- …in preparation for national committee for quality assurance (NCQA) and utilization review accreditation commission (URAC) certifications. * Provides leadership ... Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of… more
- Molina Healthcare (Dallas, TX)
- …candidate with a RN licensure, Diagnosis-Related Group (DRG) experience, 2 years of Utilization Review and/or Medical Claims Review experience. Knowledge in ... managed care experience in the specific programs supported by the plan such as utilization review , medical claims review , long-term services and supports… more
- Texas Health Resources (Arlington, TX)
- …Upon Hire Required And CPR - Cardiopulmonary Resuscitation Upon Hire Required And ACM - Accredited Case Manager Upon Hire Preferred Or CCM - Certified Case ... Manager Upon Hire Preferred Or CPUM - Certified Professional Utilization Manager Upon Hire Preferred Or Other ANCC Upon Hire Preferred Skills Knowledge of… more
- Deloitte (Dallas, TX)
- …Experience as clinical registered nurse, physician, physician assistant, case manager , clinical documentation specialist, utilization review , informatics ... skills to collaborate with clinicians, physicians, NP/PAs, ancillary departments, Quality, Case Management, Finance, Revenue Cycle, and Coders + Other skills include… more
- CenterWell (Arlington, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... precise + Identify critical issues for high-risk patients during case reviews & other forums, and modeling and driving...of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and… 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 ... clinical reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and external physicians.… more
- J&J Family of Companies (Dallas, TX)
- …differentiation with approved clinical studies and marketing aids to support the case for adoption. Achieve all sales performance goals and objectives for ... not limited to call plan attainment, resource execution and utilization , compliance and sales training requirements. + Consistently adhere...your time. Here's What You Can Expect + Application review : We'll carefully review your CV to… more