Utilization Manager Jobs in Dallas
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Search Results - Utilization Manager Jobs in Dallas
Gainwell Technologies LLCDallas
comprehensive leadership and technical development academies to help build your skills and capabilities.
Summary
This leadership role is responsible for the day-to-day operations of the Utilization Management (UM) contract and serves as the single point...
Dallastiptopjob.com
have comprehensive leadership and technical development academies to help build your skills and capabilities.
Summary
This leadership role is responsible for the day:to:day operations of the Utilization Management (UM) contract and serves...
MD Staff Pointe, LLCDallaswhatjobs.com
activities across utilization management, quality initiatives, pharmacy collaboration, provider performance, and member/provider education.
Key Responsibilities Include:
• Reviewing prior authorizations and appeals for medical necessity
• Conducting peer...
Dallastiptopjob.com
for drugs, therapeutic drug classes, and utilization management edits/criteria
• Research and explain clinical and business aspects of drugs and drug strategies to internal business partners and the Client
• Stay informed of upcoming changes in the drug market...
BAS HealthcareDallaswhatjobs.com
transition to permanent role
• Reviews prior authorization and appeals requests based on medical necessity
• Performs peer-to-peer calls to support utilization management processes
• Provides clinical oversight for utilization management, disease management...
Dallastiptopjob.com
Operational functions, including member enrollment, claims adjudication, provider data management, utilization management, and care management.
• Ability to perform deep research across application and infrastructure options leading to sound recommendations...
Parkland HealthDallaswhatjobs.com
Location: Mockingbird Towers 4th FLR
PCHP - Parkland Community Health Plan
Remote
PRIMARY PURPOSE
Oversees medical coordination required for effective utilization and quality management of the health plan network. Supports the clinical activities...
Texas Health ActionDallasworkable.com
care.
• Demonstrate fiscal responsibility in clinical decision-making by actively participating in resource and utilization management. This may include but is not limited to making cost-effective choices regarding laboratory testing, medication...
Med NinjasDallaswhatjobs.com
prior authorization and appeals request for approval or denial of claims payment based on medical necessity.
• Performs peer to peer calls as necessary to support the utilization management process.
• Provides clinical oversight for utilization...
Dallasicims.com
of education and experience required to include 2+ years of direct clinical care OR 2+ years of case management/utilization management required.
Skills & Knowledge:
• Knowledge of workers' compensation laws and regulations
• Knowledge of case management...
Dallastiptopjob.com
team where healthcare is more than just a job-it's a passion to serve and improve lives every day.
Primary Purpose
Oversees medical coordination required for effective utilization and quality management of the health plan network. Supports...
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