• Director of Case Management

    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
    Scottish Rite for Children (11/11/24)
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  • Program Mgr UR/ Case Management

    UTMB Health (Friendswood, TX)
    …resource utilization to Director and/or Assistant Director of Utilization Review/ Case Management . + Maintains a documentation system of all ... ensure optimal quality, cost, and service/outcomes. Supports and actualizes the UTMB Utilization Review/ Case Management program by utilizing clinical… more
    UTMB Health (12/20/24)
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  • Utilization Review Case Mgr-…

    UTMB Health (Webster, TX)
    …efficient use of medically appropriate services. Integrates and coordinates utilization management activities, care coordination, discharge planning functions, ... UTMB TDCJ Hospital to specialty services hospitals. **_ESSENTIAL JOB FUNCTIONS_** **:** Utilization Management + Demonstrates thorough knowledge of Inter Qual… more
    UTMB Health (01/14/25)
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  • Director of Case Management

    Houston Methodist (The Woodlands, TX)
    …promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position deploys population-focused teams to ... At Houston Methodist, the Director Case Mgmt Social Svcs position...in the areas of care coordination, evidence- based practice, utilization management , and service excellence. Disseminates information… more
    Houston Methodist (01/06/25)
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  • Director Case Management

    HCA Healthcare (Pasadena, TX)
    …**Introduction** Do you want to join an organization that invests in you as a Director Case Management ? At HCA Houston Healthcare Southeast, you come first. ... make a difference. We are looking for a dedicated Director Case Management like you...to ensure continuity of care and optimal clinical resource utilization . The Director has oversight for all… more
    HCA Healthcare (01/07/25)
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  • Associate Director , Postmarketing PV…

    United Therapeutics (Austin, TX)
    …pulmonary diseases, and other orphan diseases. **How you'll contribute** The Associate Global PV Case Management Director plays a key role in management ... processing for commercial UT products, including PM GSD workflows; Maintain unified PM Case Management operating procedures and monitor systems to ensure all PM… more
    United Therapeutics (12/14/24)
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  • Manager of Case Management

    Houston Methodist (Baytown, TX)
    …Medical Claims Review, Precertification and Reconsiderations and Appeals. Collaborates with the Director of Case Management /Social Svcs on criteria and ... + Master's in nursing preferred **WORK EXPERIENCE** + Five years experience in inpatient case management , social work or utilization management or in the… more
    Houston Methodist (01/04/25)
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  • Medical Director --Claims Management

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (10/29/24)
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  • Nursing Manager of Case Management

    HCA Healthcare (Austin, TX)
    …The Manager for Case Management Services reports to the Case Management Director and is responsible for promoting patient-centered care ... supporting a balance of optimal care and appropriate resource utilization . + You will serve as a role model...daily, weekly, and monthly reports as assigned by the Director of Case Management . +… more
    HCA Healthcare (12/13/24)
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  • Director Care Management

    Methodist Health System (Dallas, TX)
    …assessment of anticipated impact of external regulations and cost-containment efforts related to Utilization Review, Case Management . * Attains all agreed to ... implementing and supervising the day-to-day operation of the Care Management and Utilization Management Programs...of Federal, State and regulatory requirements in quality assessment, case management , resource management , hospital… more
    Methodist Health System (01/01/25)
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  • Medical Director - Gulf South

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (12/03/24)
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  • Medical Director - Mid West Region

    Humana (Austin, TX)
    …and interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , ... Case managers or Care managers on complex case management , including familiarity with social determinants...size of region or line of business. The Medical Director conducts Utilization Management of… more
    Humana (10/29/24)
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  • Registered Nurse Case Manager Market Float…

    HCA Healthcare (El Paso, TX)
    …The Manager for Case Management Services reports to the Case Management Director and is responsible for promoting patient-centered care ... supporting a balance of optimal care and appropriate resource utilization . Essential Functions: + Serves as a role model...daily, weekly and monthly reports as assigned by the Director of Case Management . Experience… more
    HCA Healthcare (12/15/24)
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  • Supervisor Registered Nurse Case Manager

    HCA Healthcare (Houston, TX)
    …nurses set us apart from any other healthcare provider. We are seeking a(an) Case Management Supervisor RN to join our healthcare family. **Benefits** Texas ... - and empowers their passion for patient care. Apply today for our Case Management Supervisor RN opportunity. **Job Summary and Qualifications** The Supervisor… more
    HCA Healthcare (11/27/24)
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  • Associate Director , Technology Project…

    Wolters Kluwer (Dallas, TX)
    …Group (*/dxg), a Division of Wolters Kluwer, is searching for an **Associate Director , Technology Project/Program Management ,** reporting into the Director , ... to help businesses better manage their practices and processes. This includes utilization of project management methodologies and tools for managing the… more
    Wolters Kluwer (01/15/25)
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  • RN Case Manager

    HCA Healthcare (Live Oak, TX)
    …patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates ... of 3 years clinical experience in area in which Case Management will be performed. + Prefer...one year experience in utilization review, resource management , discharge planning or case management more
    HCA Healthcare (01/14/25)
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  • RN Case Manager PRN

    HCA Healthcare (San Antonio, TX)
    …patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding departmental functions. The CM coordinates ... of 3 years clinical experience in area in which Case Management will be performed. + Prefer...one year experience in utilization review, resource management , discharge planning or case management more
    HCA Healthcare (01/11/25)
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  • Director of Quality Management

    Select Medical (Temple, TX)
    …Temple** **725 Marlandwood Rd, Temple, TX, 76502** ** Director of Quality Management ** **(DQM)** ... protected under applicable law_ _._ Apply for this job (https://jobs-selectmedicalcorp.icims.com/jobs/315796/ director -of-quality- management inpatient-rehab/job?mode=apply&apply=yes&in\_iframe=1&hashed=1374627814) Share this job **Job ID**… more
    Select Medical (01/17/25)
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  • Director Care Management - Aetna…

    CVS Health (Austin, TX)
    …organization-wide business functions including claims, member services, compliance, quality, utilization management , and network/provider services. + Serve as ... unencumbered license and experienced in the activities of Care Management . + Nationally recognized case management certification, or ability to obtain within… more
    CVS Health (01/04/25)
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  • Associate Director , Thought Leader…

    J&J Family of Companies (Austin, TX)
    Johnson & Johnson is recruiting for an Associate Director , Thought Leader Liaison, Neurology Rare Disease to support the Mountain Region. This is a field-based ... reach their potential. At Johnson & Johnson, we all belong. The Associate Director Thought Leader Liaison's (TLL) key primary responsibility is to support US… more
    J&J Family of Companies (01/09/25)
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