- Scottish Rite for Children (Dallas, TX)
- …committed to giving children back their childhood! Job Posting Title: Director of Case Management and Utilization Management Location: Dallas - ... Details: Monday - Friday 8:00am to 4:30pm Job Description: Duties/Responsibilities: + Utilization Management supporting medical necessity and denial prevention +… more
- HCA Healthcare (Lewisville, TX)
- …a work environment where diversity and inclusion thrive? Submit your application for our Director Case Management opening with Medical City Lewisville today ... benefits may vary by location._** We are seeking a(an) Director Case Management for our...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
- Select Medical (Frisco, TX)
- …**Baylor Scott & White Institute for Rehabilitation** _Frisco, TX_ ** Director of Quality Management ** **(DQM)** **Responsibilities** **Position Summary** ... protected under applicable law_ _._ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/311085/ director -of-quality- management inpatient-rehab/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this job **Job ID**… more
- Elevance Health (Grand Prairie, TX)
- …preferred. + Extensive orthopedic surgery experience preferred. + Experience with utilization management , especially with CMS guidelines preferred. For ... **Clinical Ops Associate Medical Director - Ortho** **Location:** **This is a virtual...necessity of requests using clinical criteria. + Performs physician-level case review of musculoskeletal utilization requests. +… more
- Molina Healthcare (Dallas, TX)
- …+ Delivers a unified or fully Integrated DSNP Medicare and Medicaid model that ensures case management and utilization management work cohesively to ... manage the needs of members holistically + Supports case management transformation and Integrated case...State Registered Nursing (RN) license in good standing. + Utilization Management Certification (CPHM) Certified Professional in… more
- Bayer (Fort Worth, TX)
- …diverse minds to make a real difference, there's only one choice.** **Associate Director , Regional Marketing - Oncology - North and South Texas** **Associate ... Director Regional Marketing - Oncology - North and South...responsible for activities across five key areas, in each case , acting as a champion to deliver brand communication… more
- Molina Healthcare (Dallas, TX)
- …across Molina Health Plans & Segments. **KNOWLEDGE/SKILLS/ABILITIES** + Review existing case management standards and processes and establishes new standards ... to drive clinical excellence and quality results across the enterprise. + Identifies case management best practices and capabilities across all plans and Lines… more
- HCA Healthcare (Fort Worth, TX)
- …care issues. Offers clinical support for appeals and denials process, discharge planning, case management , and utilization review/ management + You ... will consult with facility-level staff regarding delegated utilization management and disease management ...the denial and appeals process, as requested by the Case Management Department and Patient Accounting Services… more
- CenterWell (Grapevine, TX)
- …performance review and outcomes of care analysis to determine efficiency, the efficacy of case management system as well as any other systems and process. ... the delivery of care to all patients served by the location. Receives case referrals. Reviews available patient information related to the case , including… more