931 Utilization Management jobs in Houston,TX

Program Manager, Healthcare Services (Behavioral Health)

Molina Healthcare

Houston, TX 77001

$73,102-$142,549/yr

Onsite

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

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New, Posted 8 hours ago

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Onboarding Specialist

Nestle

Houston, TX 77001

Assistant Store Manager (Bilingual)

Community Choice Financial Family of Brands

Pasadena, TX 77504

$16/hr

Bilingual Preferred

Culinary Agents

Executive Sous Chef

Le Colonial - Houston

Houston, TX 77027

Bilingual Preferred

Recommended

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Property Adjuster Specialist - Field

USAA

Houston, TX 77002

HybridHealth InsurancePaid Time OffRetirement Benefit

High School Diploma or General Equivalency Diploma required.
2 years of relevant property claims adjusting experience of moderate complexity losses that includes writing estimates, involving dwelling and structural damages.
Advanced knowledge of estimating losses using Xactimate or similar tools and platforms.
Proficient knowledge of residential construction.
Proficient knowledge of property claims contracts and interpretation of case law and state laws and regulations.
Proficient negotiation, investigation, communication, and conflict resolution skills.
Proven investigatory, analytical, prioritizing, multi-tasking, and problem-solving skills.
Ability to travel 50-75% of the year (local & non-local) and/or work catastrophe duty when needed.
Acquisition and maintenance of insurance adjuster license within 90 days and 3 attempts.
May require the ability to crouch and stoop to inspect confined spaces, to include attics and go beneath homes into crawl spaces.
May need to meet all USAA safe driving requirements including verification of driving record through MVR & possession of valid driver's license.
May require the ability to lift a minimum of 35 pounds to include lifting a ladder in and out of the trunk of a car.
May require the ability to climb ladders and traverse roofs, this includes the ability to work at heights while inspecting roofs and attics.

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New, Posted 1 day ago

Wastewater Plant Technician II

Waste Resource Management

Houston, TX 77008

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Cleaner

Airtasker

Houston, TX 77084

OnsiteFlexible Schedule

Must be 18 years or older
Must have an iPhone or Android smartphone
Must provide tools necessary to complete each type of job you choose to take on
Must be willing to close jobs using Airtasker and provide excellent customer service

SmartExplore AI is experimental.

Culinary Agents

Produce Department Supervisor - Full Time

Whole Foods

Houston, TX 77057

$15.50-$29.20/hr

Flexible Schedule

New, Posted 1 day ago

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Structural Fitter

Southwest Shipyard Lp

Houston, TX 77012

OnsiteBilingual PreferredHealth InsurancePaid Time OffRetirement Benefit

Must have or be eligible to obtain a TWIC card.
Minimum one year experience as a structural fitter (shipyard experience preferred, but not required)
Be able to perform simple paper work as required for filling out forms and logs.
Must have good judgment skills and work initiative, taking good directions from Supervisor/Manager.
Understanding of company Quality, Environmental & Safety manual and procedures described therein.
High school graduate or equivalent.
Must have good communication skills and leadership ability, English & Spanish (Bi-lingual required).

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Pharmacist - Clinical Programs Manager (Days)

Texas Childrens Hospital

Bellaire, TX 77401

~ 9 min Onsite

Bachelor's Degree Science in Pharmacy OR Pharm. D. Doctor of Pharmacy required
RPH - Pharmacist by the State of Texas required
3 years Managed care experience at a health plan or PBM working in utilization management, analytics, formulary management, and/or clinical literature required

SmartExplore AI is experimental.