This position focuses on optimizing patient outcomes, managing care utilization, and supporting ... Graduate of an approved college or university with a at least a diploma or an associate's degree in ...
This position focuses on optimizing patient outcomes, managing care utilization, and supporting ... Graduate of an approved college or university with a at least a diploma or an associate's degree in ...
This position focuses on optimizing patient outcomes, managing care utilization, and supporting ... Graduate of an approved college or university with a at least a diploma or an associate's degree in ...
This position focuses on optimizing patient outcomes, managing care utilization, and supporting ... Graduate of an approved college or university with a at least a diploma or an associate's degree in ...
This position focuses on optimizing patient outcomes, managing care utilization, and supporting ... Graduate of an approved college or university with a at least a diploma or an associate's degree in ...
This position focuses on optimizing patient outcomes, managing care utilization, and supporting ... Graduate of an approved college or university with a at least a diploma or an associate's degree in ...
Wealth Management Associate participants partner with Financial Advisors in a branch or complex to ... brand utilization of the resources in the branch or complex. • Learn and practice client ...
Wealth Management Associate participants partner with Financial Advisors in a branch or complex to ... brand utilization of the resources in the branch or complex. • Learn and practice client ...
Wealth Management Associate participants partner with Financial Advisors in a branch or complex to ... brand utilization of the resources in the branch or complex. • Learn and practice client ...
Wealth Management Associate participants partner with Financial Advisors in a branch or complex to ... brand utilization of the resources in the branch or complex. • Learn and practice client ...
Associate Clinical Director
The Woodlands, TX · On-site
$112K - $117K/yr
Utilization Management: Conduct Daily and weekly reviews and problem solving with supervisors of ... Associate Clinical Supervisor ratio compliance * Developing and monitoring SV cases loads and ...
Associate Clinical Director
The Woodlands, TX · On-site
$112K - $117K/yr
Utilization Management: Conduct Daily and weekly reviews and problem solving with supervisors of ... Associate Clinical Supervisor ratio compliance * Developing and monitoring SV cases loads and ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site +1
$100K - $160K/yr
... utilization management -- but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site +1
$100K - $160K/yr
... utilization management -- but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site
$100K - $160K/yr
... utilization management -- but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site
$100K - $160K/yr
... utilization management -- but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site +1
$100K - $160K/yr
... utilization management -- but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site +1
$100K - $160K/yr
... utilization management -- but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site
$100K - $160K/yr
... utilization management - but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Associate Attorney - Healthcare - Technology - Privacy
Houston, TX · On-site
$100K - $160K/yr
... utilization management - but it also faces the tightest regulatory tightrope of any industry. We ... This isn't a generic privacy or healthcare associate role. You'll work where HIPAA compliance meets ...
Operation Manager
TX · On-site
... activities, space utilization & management, and equipment management. People management ... Associates are expected to comply with all corporate and site-specific policies. ESSENTIAL DUTIES ...
Operation Manager
TX · On-site
... activities, space utilization & management, and equipment management. People management ... Associates are expected to comply with all corporate and site-specific policies. ESSENTIAL DUTIES ...
Operation Manager
Hockley, TX · On-site
... activities, space utilization & management, and equipment management. People management ... Associates are expected to comply with all corporate and site-specific policies. ESSENTIAL DUTIES ...
Operation Manager
Hockley, TX · On-site
... activities, space utilization & management, and equipment management. People management ... Associates are expected to comply with all corporate and site-specific policies. ESSENTIAL DUTIES ...
Clinical Director
The Woodlands, TX · On-site
$112K - $117K/yr
Utilization Management: Conduct Daily and weekly reviews and problem solving with supervisors of ... Associate Clinical Supervisor ratio compliance * Developing and monitoring SV cases loads and ...
Clinical Director
The Woodlands, TX · On-site
$112K - $117K/yr
Utilization Management: Conduct Daily and weekly reviews and problem solving with supervisors of ... Associate Clinical Supervisor ratio compliance * Developing and monitoring SV cases loads and ...
Clinical Director
Katy, TX · On-site
$112K - $117K/yr
Utilization Management: Conduct Daily and weekly reviews and problem solving with supervisors of ... Associate Clinical Supervisor ratio compliance * Developing and monitoring SV cases loads and ...
Clinical Director
Katy, TX · On-site
$112K - $117K/yr
Utilization Management: Conduct Daily and weekly reviews and problem solving with supervisors of ... Associate Clinical Supervisor ratio compliance * Developing and monitoring SV cases loads and ...
Equipment Readiness Associate
Katy, TX · On-site
... utilization and efficiency of assets. * This person reduces the cost of service delivery (CoSD ... Execute work orders (WOs) as assigned through the Computerized Maintenance Management System for ...
Equipment Readiness Associate
Katy, TX · On-site
... utilization and efficiency of assets. * This person reduces the cost of service delivery (CoSD ... Execute work orders (WOs) as assigned through the Computerized Maintenance Management System for ...
... utilization of resources. Serve as the primary escalation point for field personnel requiring ... Experience with electrical safety programs and field service operations management. Associate's or ...
... utilization of resources. Serve as the primary escalation point for field personnel requiring ... Experience with electrical safety programs and field service operations management. Associate's or ...
... utilization of resources. Serve as the primary escalation point for field personnel requiring ... Experience with electrical safety programs and field service operations management. Associate's or ...
... utilization of resources. Serve as the primary escalation point for field personnel requiring ... Experience with electrical safety programs and field service operations management. Associate's or ...
... utilization of resources. Serve as the primary escalation point for field personnel requiring ... Experience with electrical safety programs and field service operations management. Associate's or ...
Quick apply
... utilization of resources. Serve as the primary escalation point for field personnel requiring ... Experience with electrical safety programs and field service operations management. Associate's or ...
Equipment Readiness Associate
Katy, TX · On-site
$20/hr
... utilization and efficiency of assets. This person reduces the cost of service delivery (CoSD ... Execute work orders (WOs) as assigned through the Computerized Maintenance Management System for ...
Equipment Readiness Associate
Katy, TX · On-site
$20/hr
... utilization and efficiency of assets. This person reduces the cost of service delivery (CoSD ... Execute work orders (WOs) as assigned through the Computerized Maintenance Management System for ...
With over 35 years of cross-industry management consulting experience, DeWolff, Boberg & Associates ... Thoroughly understand client resource utilization to identify waste in time and resources to ...
With over 35 years of cross-industry management consulting experience, DeWolff, Boberg & Associates ... Thoroughly understand client resource utilization to identify waste in time and resources to ...
Utilization Management Associate information
What does a utilization management associate do?
A Utilization Management Associate is responsible for reviewing healthcare services and determining whether they are medically necessary, appropriate, and efficient. They work with healthcare providers, insurance companies, and patients to ensure that treatments comply with established guidelines and policies. Their role often includes reviewing medical records, processing authorizations, and assisting in the coordination of care to optimize the use of healthcare resources. This position helps control costs while ensuring that patients receive the appropriate level of care.
What skills and qualifications are needed to thrive as a utilization management associate?
A Utilization Management Associate typically needs a background in healthcare administration or a related field, strong analytical skills, and knowledge of medical terminology and insurance guidelines. Familiarity with utilization review software, electronic health records (EHRs), and regulatory compliance systems is important, and certifications like Certified Professional in Healthcare Management (CPHM) can be advantageous. Attention to detail, effective communication, and strong organizational skills help associates excel in evaluating medical necessity and collaborating with care teams. These competencies ensure accurate, efficient review processes that support quality patient care and compliance with payer requirements.
What are the typical daily responsibilities of a utilization management associate?
Utilization Management Associates typically review medical records, verify insurance coverage, and coordinate with healthcare providers to ensure that treatments and services meet established guidelines and payer requirements. They also communicate with physicians and patients to gather necessary information for authorization requests. By ensuring appropriate utilization of healthcare resources, they help support patient care while managing costs and compliance for their organization. Collaboration with clinical staff and insurance representatives is a key part of the role, contributing to effective case management.
What is the difference between Utilization Management Associate vs Utilization Review Coordinator?
| Aspect | Utilization Management Associate | Utilization Review Coordinator |
|---|---|---|
| Certifications | Typically requires a healthcare-related certification or license | Often requires similar certifications, such as CCM or RHIA |
| Work Environment | Works in insurance companies, healthcare providers, or managed care organizations | Works in hospitals, insurance companies, or healthcare facilities |
| Job Focus | Assists in reviewing medical necessity and authorization processes | Coordinates and conducts utilization reviews and approvals |
| Common Usage | Used interchangeably in healthcare and insurance settings | Often used in hospital and insurance contexts |
The Utilization Management Associate and Utilization Review Coordinator roles share similarities in certifications and work environments, focusing on reviewing medical necessity and authorization. The main difference lies in their specific responsibilities, with associates assisting in the process and coordinators actively conducting reviews and approvals.
What are the most commonly searched types of Utilization Management jobs in Houston, TX?
The most popular types of Utilization Management jobs in Houston, TX are:
What cities near Houston, TX are hiring for Utilization Management Associate jobs?
Cities near Houston, TX with the most Utilization Management Associate job openings:
Utilization Review Nurse Home Health Registered Nurse
Houston, TX • On-site
Doctor's Choice Home Care & Hospice Texas
Full-time
Posted 7 days ago
Job description
Summary of Essential Functions for the Position:
Committed to Caring, the Utilization Review Nurse (RN) is responsible for reviewing clinical documentation, patient plans of care, and utilization patterns to ensure appropriate, effective, and compliant delivery of home health services. This position focuses on optimizing patient outcomes, managing care utilization, and supporting clinicians in providing the right care at the right time. The Utilization Review Nurse collaborates closely with field clinicians, case managers, and leadership to promote efficiency, quality, and regulatory compliance across all episodes of care.
Qualifications / Licensure / Certification / Knowledge / Skills / Abilities:
- Current and active RN license in the state of practice required.
- Minimum 2 years of experience in home health, quality assurance, or utilization management preferred.
- Knowledge of Medicare Conditions of Participation (CoPs), OASIS documentation, and home health regulatory standards.
- Experience with EMR systems (Wellsky and WellSky CareInsights or equivalent preferred).
- Excellent analytical, communication, and critical-thinking skills.
- Ability to work independently while collaborating effectively with interdisciplinary teams.
- Knowledge of clinical pathways and evidence-based care guidelines.
- Strong organizational and time-management abilities.
- Proficient in data analysis and documentation review.
- Acceptance and ability to demonstrate support of the core values and goals of Agency.
- Ability to demonstrate flexibility, initiative, and work with minimal supervision.
- Strong communication skills, both oral and in writing, with excellent interpersonal skills.
Educational Requirements:
High School Diploma or GED. Graduate of an approved college or university with a at least a diploma or an associate's degree in nursing (ADN) from an accredited nursing program.
Working Conditions & Physical Requirements:
Work environment includes autonomy and can be stressful due to deadlines, multiple tasks and general compliance of law, rules, and regulations. The position requires visual acuity and dexterity, sitting, standing, some pushing, pulling, and lifting up to 25 pounds.