4125 Case Manager jobs in Cedar Hill,TX

Program Manager, Healthcare Services (Behavioral Health)

Molina Healthcare

Fort Worth, TX 76104

At least 5 years of health care experience, including experience in clinical operations, and at least 3 or more years in one or more of the following areas: utilization management, care management, care transitions, behavioral health, or equivalent combination of relevant education and experience.
Registered Nurse (RN), Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Advanced Practice Social Worker (APSW), Certified Health Education Specialist (CHES), Licensed Professional Counselor (LPC), Licensed Professional Clinical Counselor (LPCC) or Licensed Marriage and Family Therapist (LMFT). Clinical licensure and/or certification required ONLY if required by state contract, regulation, business operating model, or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
Strong analytical and problem-solving skills.
Strong organizational and time-management skills.
Ability to work in a cross-functional, professional environment.
Experience working within applicable state, federal, and third-party regulations.
Strong verbal and written communication skills.
Microsoft Office suite/applicable software program proficiency, and ability to navigate online portals and databases.
Ability to travel up to 30% throughout state of Texas.
Employee for this role must reside in Texas

Walmart

Duncanville, TX 75137

USAA

Dallas, TX 75221

High School Diploma or General Equivalency Diploma.
4+ years of P&C; SIU/Fraud investigation experience; OR 6+ years relevant fraud industry investigation experience.
Expert knowledge and understanding of fraud investigations as well as application of case law and state laws and regulations.
Must be a skilled investigator with experience taking sophisticated statements from multiple parties to an event.
Ability to capture broad range of evidence and draw conclusions based on the objective details related to the applicability of fraud.
Demonstrated ability to coordinate and prioritize workload, performing multiple tasks and devising solutions to problems.
Experience using computers and various software packages to enter and extract data for analysis from relevant data sources and systems.
Knowledge of city, state and local regulations, legal concepts, understanding of contracts, case law, medical treatment, and medical terminology.
Experience in concurrent handling of specialty/complex/litigated claims/cases as well as mediation/arbitration/trial preparation and participation.
Meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license.
US military experience through military service or a military spouse/domestic partner