- 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
- HCA Healthcare (Arlington, TX)
- …step in your career path, we encourage you to apply for our Registered Nurse Case Manager opening. We review all applications. Qualified candidates will be ... you have the career opportunities as a Registered Nurse Case Manager you want in your current...supporting a balance of optimal care and appropriate resource utilization . What You Will Do In This Role: +… more
- Elevance Health (Grand Prairie, TX)
- **Telephonic Nurse Case Manager II** **Location: This role enables associates to work virtually full-time, with the exception of required in-person training ... assessment within 48 hours of receipt and meet the criteria._** The **Telephonic Nurse Case Manager II** is responsible for care management within the scope of… more
- CenterWell (Cleburne, TX)
- …action through the utilization of Performance Improvement principles. + Responsible for review of the appropriate number of Case Managers and clinical staff ... comes with a $10K sign-on bonus.** + The **Clinical Manager ** coordinates and oversees all direct care patient services...clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the… more
- Elevance Health (Grand Prairie, TX)
- …supervision. **Preferred Skills, Capabilities and Experiences:** + Previous experience in case management/ utilization management with a broad range of experience ... **Behavioral Health Care Manager I** **Virtual:** This role enables associates to...outpatient professional treatment health benefits through telephonic or written review . **How you will make an impact** Primary duties… more
- Molina Healthcare (Fort Worth, 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 (Fort Worth, TX)
- …Management (CPHM), Certified Professional in Health Care Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society of ... oversight and clinical leadership for health plan and/or market specific utilization management and care management behavioral health programs and chemical… 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
- Texas Health Resources (Bedford, 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
- 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 ... for clinical operational aspects of a program. + Conduct peer-to-peer clinical appeal case reviews with attending physicians or other ordering providers to discuss … more
- Elevance Health (Grand Prairie, TX)
- …program, including Prior Authorizations, Medication Therapy Management (MTM), Lock-in, and Drug Utilization Review (DUR) programs. **How you will make an ... the Pharmacy and Therapeutics Committee including therapeutic class reviews, policy review , drug monographs, and formulary recommendations. + Develop strategies to… more
- Molina Healthcare (Fort Worth, TX)
- …Healthcare Management (CPHM), Certified Professional in Healthcare Quality (CPHQ), Commission for Case Manager Certification (CCMC), Case Management Society ... and expertise in performance of prior authorization, inpatient concurrent review , discharge planning, care management and interdisciplinary care team (ICT)… more
- Elevance Health (Grand Prairie, TX)
- …Medical Director** **Carelon Medical Benefits Management** **Radiology Benefit Management/ Utilization Review ** **Virtual:** This role enables associates ... necessity decisions. + Brings to their supervisors attention, any case review decisions that require + Medical...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more