PRIOR AUTHORIZATION UTILIZATION MANAGEMENT jobs in AUSTIN TX, United Kingdom

, Excel) Preferred Qualifications Prior Authorization or Utilization Management experience Managed care experience... our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary Utilization...

to ensure level of care and services are medically appropriate Performs prior authorization reviews related to mental health... Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...

of care that includes the utilization of authorized hours, the vetting of potential candidates, and the management... authorization and client family needs in order to determine feasibility and financial responsibility regarding therapy services...

will also assist with providing strategic direction to the Novologix Prior Authorization Operations leadership teams within the..., pharmacy management, formulary management, drug utilization, managed care pharmacy, pharmacy benefit management, and third...

, other APPs. and health care team members in clinical evaluation and management and communicating the clinical management plan... on-going inpatient and outpatient care and management Manage and direct communications between health care team and pediatric...

of experience in healthcare setting preferred. Prefer prior experience in case management, utilization review, or discharge..., utilization review and management, and discharge planning. Essential Functions: Care Coordination Coordinates clinical...

reviews and reviews of claim determinations. This includes Prior Authorization / Pre Certification / Concurrent Reviews... of clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of care...

for cost savings and improved patient outcomes Provide expertise in drug utilization management and prior authorization...) and Managed Care. In this pivotal role, you will be responsible for overseeing medication utilization, formulary management...