Utilization management Jobs in Texas

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Principal Software Engineer - Utilization Management

CVS Health

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Remote or Wellesley, Massachusetts, USA

Full-time

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all w
Posted 60+ days ago | Updated 4 hours ago

Utilization RN

Pyramid Consulting, Inc.

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Remote

Contract

Immediate need for a talented Utilization RN. This is a 10+months contract opportunity with long-term potential and is located in Dallas,TX(Remote). Please review the job description below and contact me ASAP if you are interested. Job ID:25-69315 Pay Range: $35 - $38/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location). Key Responsibilities: Analyzes all prior authorization requests to
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Posted 10 days ago

Application Engineer (m/w/d) - Schwei- und Befestigungslsungen

Stanley Black and Decker

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Remote

Full-time

Application Engineer (m/w/d) bei STANLEY Engineered Fastening ber uns: Stanley Black & Decker steht seit 1843 fr innovative Lsungen und Werkzeuge, die weltweit bekannt und geschtzt sind. Unsere Division, STANLEY Engineered Fastening, ist der globale Marktfhrer fr Przisionsbefestigungs- und Montagelsungen. Wir bieten Ingenieur*innen in den Bereichen Automobil, Luft- und Raumfahrt sowie Industrie innovative Produkte, die Effizienz, Zuverlssigkeit und Qualitt in Fertigungsprozessen sicherstelle
Posted 49 days ago | Updated 4 hours ago

Software Engineering Senior Advisors- Hybrid

Cigna

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Remote or St. Louis, Missouri, USA

Full-time

The job profile for this position is Software Engineering Senior Advisor, which is a Band 4 Contributor Career Track Role with Cigna-Evernorth Services Inc. Responsibilities- Full stack software engineer responsible for developing patterns, processes, and applications that enable other Scrum teams to tackle big data and data science problems.Understand business requirements and work with cross-organizational teams. Utilize big data methodologies to solve business problems through application dev
Posted 2 days ago | Updated 4 hours ago

Data Analyst III Medical Economics

Centene Corporation

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Florida, USA

Full-time

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Analyze integrated and extensive datasets to extract value, which directly impacts and influences business decisions. Work collaboratively with key business stakeholders to identify areas of v
Posted 38 days ago | Updated 4 hours ago

Clinical Data Governance Lead - Enterprise Quality & Accreditation - Hybrid

Cigna

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Remote or Bloomfield, Connecticut, USA

Full-time

Role Summary: Effective execution of good data governance principles and practices minimizes risk and ensures the data is available and fit for purpose. As part of The Cigna Group's Enterprise Clinical & Health Organization (ECHO), the Clinical Data Governance Lead is responsible for overseeing the integrity, quality, and governance of data critical to ECHO operations, programs, and strategies. Ideal candidates should have strong background on health care payer Clinical operations / programs an
Posted 46 days ago | Updated 4 hours ago

Lead Strategy Officer for Express Scripts & Evernorth Care Management (Managing Director)(Hybrid)

Cigna

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Remote or St. Louis, Missouri, USA

Full-time

Lead Strategy Officer for Express Scripts & Evernorth Care Management will support and report directly to the Express Scripts & Evernorth Care Management Technology CIO and serve as an integral member of the Lead Team. This role will be responsible for leading the development and execution of the organization's strategy, technology operations management, portfolio management, and act as a key advisor for internal business partners. The COO role involves aligning IT initiatives with business goal
Posted 10 days ago | Updated 4 hours ago

Medical Director, Behavioral Health with certification in psychiatry

BlueCross BlueShield of Tennessee Inc.

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Remote

Full-time

Are you a dedicated and experienced medical professional with a passion for quality improvement and healthcare administration? We are seeking a self-motivated and detail oriented Medical Review Director to lead our team in ensuring the highest standards of medical necessity determinations and clinical metrics analysis. You may be a great match for this role if you are a versatile board-certified psychiatrist with management experience in the areas of behavioral health and addiction medicine. We
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Posted 38 days ago | Updated 23 days ago

Healthcare Integration Architect

ChaTeck Incorporated

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Remote or Bellevue, Washington, USA

Contract, Third Party

Position Title: Healthcare Integration Architect Location: US - Remote (EST hours) Job Type: Full-Time Let's create our future together at The AES Group! About The AES Group: The AES Group is a premier technology consulting company that has been bringing businesses and talent together for over 20 years to deliver the most innovative technology solutions that create the most positive impact on society. AES has helped over 40 business enterprises, including Fortune 500 companies, engage their