Utilization management jobs in Texas

Utilization Management Specialist (LCPC/LCSW-C)

Remote

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12d ago

Utilization Management Specialist (LCPC/LCSW-C)Introduction:The Behavioral Health Utilization Management Specialist will be responsible for performing prospective, concurrent, and retrospective reviews for authorization, appropriateness of care determination, and benefit coverage. Utilizing clinical expertise and critical thinking skills, the specialist will analyze clinical information, contracts, mandates, and medical policies to contribute to the determination of appropriateness and authoriza

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Contract

45 - 52

Authorization Coordinator I - REMOTE

Remote or Emeryville, California

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Today

Software Guidance & Assistance, Inc., (SGA), is searching for an Authorization Coordinator I for a Contract assignment with one of our premier Healthcare clients working remotely. Responsibilities : The Authorization Coordinator I processes patient referral requests to support timely and accurate determinations. This role reviews referrals according to standard work, health plan contracts, and utilization management protocols, forwarding requests to nurses or physicians when required. The coord

Contract

USD 25.00 - 25.00 per hour

IT Delivery Manager (Remote restricted in OR, WA, ID, UT or ND only)

Remote or Hybrid in Salt Lake City, Utah

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3d ago

IT Delivery Manager (Remote restricted to OR, WA, ID, UT or ND only) Our client, a leading health care company dedicated to revolutionizing the industry, is seeking an experienced Release Manager / Delivery Lead to provide end-to-end coordination and delivery leadership across multiple clinical and technology initiatives. This role will work across Product Owners, business teams, technology (DTS), configuration, UAT/quality, project resources, vendors, and operational stakeholders to ensure wor

Contract

Product Engineer III - R37

Remote

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Today

About R37 R37 is R1's AI innovation lab, building technology to transform healthcare. Our flagship platform, Phare OS, uses AI and automation to improve critical pre-bill workflows, including authorization, utilization management, documentation and coding. By identifying and resolving issues before claims are submitted, Phare OS helps prevent denials, improve reimbursement and move revenue cycle work upstream. What makes R37 different is the opportunity to build advanced AI at real-world scale.

Full-time

USD 105,000.00 - 202,500.00 per year

Product Engineer II - R37

Remote

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Today

Full-time

USD 105,000.00 - 202,500.00 per year

Director, Engineering - AI-First Healthcare Transformation

Dallas, Texas

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28d ago

Become a part of our caring community Healthcare is entering the most consequential technology shift of the next decade - and Humana is at the center of it. We're seeking a Director of Engineering to lead the AI-first transformation of our clinical technology organization, embedding AI-assisted engineering, agentic workflows, and modern data platforms directly into how we build, test, and deliver enterprise healthcare systems. This isn't an incremental modernization role. You'll be building the

Full-time

USD 172,200.00 - 236,900.00 per year

Avionic Engineering Architect III

Grand Prairie, Texas

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Today

Airbus is committed to providing reasonable accommodations as an Equal Opportunity Employer to applicants with disabilities. If you require assistance or an accommodation to complete your application, please contact us at Notice: Know Your Rights: Workplace Discrimination is IllegalNotice: Pay Transparency Nondiscrimination (English)Aviso: Transparencia en el Pago No Discriminacion (Spanish) Job Description: Ready to shape the future of vertical flight? Airbus Helicopters is seeking a senior-le

Full-time

Principal Engineer -- Salesforce Architect

Remote or Atlanta, Georgia

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Today

Company Description We are a Digital Product Engineering company that is scaling in a big way! We build products, services, and experiences that inspire, excite, and delight. We work at scale - across all devices and digital mediums, and our people exist everywhere in the world (18000+ experts across 28 countries, to be exact). Our work culture is dynamic and non-hierarchical. We are looking for great new colleagues. That is where you come in! Job Description Lead end-to-end Salesforce Health

Full-time

Director, Broadband Network Engineering

Lubbock, Texas

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Today

Director, Broadband Network Engineering Department: Broadband - Network Engineering Services Employment Type: Full Time Location: Lubbock, TX Description JSI invites you to join our team as a Director, Broadband Network Engineering, based out of our Lubbock, TX office, where you'll play a critical role in advancing broadband and telecommunications initiatives that expand connectivity and drive digital inclusion-while advancing your career within a mission-driven, growth-focused organization

Full-time

Health Cloud Solution Architect

Remote

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Today

Why NeuraFlash, Part of Accenture: At NeuraFlash, Part of Accenture, we are redefining the future of business through the power of AI and groundbreaking technologies like Agentforce. As a trusted leader in AI, AWS, and Salesforce innovation, we craft intelligent solutions-integrating Salesforce Einstein, Service Cloud Voice, Amazon Connect, Agentforce and more-to revolutionize workflows, elevate customer experiences, and deliver tangible results. From conversational AI to predictive analytics,

Full-time

USD 94,400.00 per year

Forward Deployed Engineer (FDE) - Remote

Remote

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Today

Come to the Optum Forward Deployed Engineer Virtual Career Event on 9/16 or 9/17! This event will be set up with virtual and on-demand content, so that each participant can spend time where and how it best fits their needs and interests. Visit booths to learn more about Forward Deployed Engineer (FDE) roles at Optum. Connect with Optum Tech Talent Acquisition team members and leaders. RSVP and find more information here: Wednesday, September 16 from 11am-1pm CT | Register here Thursday, Sept

Full-time

USD 176,700.00 - 302,900.00 per year

Sr. Manager, AI/ML Engineering - Remote

Remote or Minnetonka, Minnesota

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Today

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. UnitedHealthcare is accelerating its next-generation AI transformation through Claims AI 10.0 and Ente

Full-time

USD 148,900.00 - 255,300.00 per year

Transmission Line Engineering Manager - Remote

Remote or Chicago, Illinois

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Today

Title: Transmission Line Engineering Manager Location Requirement: This position is fully remote and can only be performed in the United States. Ready to make a difference? We are seeking a Transmission Line Engineering Manager to lead and grow our new transmission line engineering practice. You will have the opportunity to help build this practice from the ground up as complimentary service to our existing substation engineering practice. In this leadership role, you will be responsible for t

Full-time

USD 174,701.00 - 296,992.00 per year

Data Scientist IV

Remote or Dayton, Ohio

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Today

Job Summary: The Data Scientist IV is responsible for leading the design, development, and operationalization of advanced analytics, machine learning, and artificial intelligence solutions that improve healthcare operations, patient outcomes, and organizational performance. This role provides technical leadership across complex initiatives involving predictive modeling, generative AI, Agentic AI, Natural Language Processing (NLP), and large-scale healthcare data science solutions. They influenc

Full-time

USD 113,000.00 - 197,700.00 per year

Applied AI Scientist IV

Remote or Dayton, Ohio

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Today

Job Summary: The Applied AI Scientist IV is responsible for establishing technical direction and leading the design, development, and operationalization of advanced artificial intelligence solutions that improve healthcare operations, patient outcomes, and organizational performance. This role provides enterprise-wide technical leadership across machine learning, Generative AI, Agentic AI, Retrieval-Augmented Generation (RAG), and Natural Language Processing (NLP) initiatives. The Applied AI Sc

Full-time

USD 113,000.00 - 197,700.00 per year

Vice President-Payer Sales

Remote

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3d ago

Position:Vice President Payer Sales Experience:15+ Years Location: Remote Role Overview Pure New Logo Hunter role focused on Healthcare Payer organizations. Responsibilities Prospect and acquire new Healthcare Payer clients. Own the complete sales cycle from lead generation through contract closure. Sell AI, Analytics, Digital Transformation, Clinical Services, Utilization Management, Care Management, Payment Integrity and Contact Center solutions. Build relationships with C

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Full-time, Third Party

Depends on Experience

Forward Deploy Engineer

Remote

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18d ago

10+ Years Exp Job Description:We are looking for a Forward Deployed Engineer with strong software engineering and hands-on AI/GenAI experience to work directly with healthcare clients. The ideal candidate will build, integrate, and deploy AI-powered solutions while working closely with client stakeholders. Key Skills: Strong experience with Python, Java, and/or SQLHands-on experience with GenAI, LLMs, Prompt EngineeringExperience integrating LLMs with APIs and enterprise systemsStrong knowledge

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Contract, Third Party

65 - 75

Healthcare Business Analyst

Remote

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4d ago

Role Summary We are seeking an experienced Healthcare Business Analyst with strong hands-on experience in Electronic Prior Authorization (ePA), CMS-0057, FHIR, and healthcare interoperability. The candidate should be able to work directly with clients, partners, product, and technical teams and contribute quickly to complex healthcare implementations. Key Responsibilities Gather, analyze, and document business and functional requirements for ePA and FHIR-based solutions.Support CMS-0057 requirem

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Contract, Third Party

$50 - $55

Medicare Appeals Professional with Licensed nurse

Remote

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26d ago

Responsibilities:Reviews medical records/case file, writes a reconsideration decision letter that is clear, concise, andimpartial and supports the determination made, and documents review.Makes sound, independent decisions based on medical evidence in accordance with statutes, regulation,rulings, and policy.Responds to and ensures that all appeal issues raised by the beneficiary/patient, representative, andprovider/supplier have been addressed.Provides a fair and impartial decision based on curr

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Full-time

Depends on Experience

BUSINESS ANALYST

Remote or Hybrid in Washington, District of Columbia

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7d ago

Business Analyst Healthcare ( 2-3 Years Experience)Company: AaraTech Inc About the RoleAaraTech Inc is seeking a motivated and detail-oriented Business Analyst Healthcare ( 2-3 years experience) to support healthcare and health plan operations through data analysis, reporting, and documentation. This role is ideal for early-career professionals looking to build a career in healthcare analytics within a regulated environment. The Business Analyst will collaborate with cross-functional teams to su

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Contract

$65,000 - $75,000

Utilization management jobs in Texas, USA