Searches

You can browse our active searches here. If you are interested in any of our ongoing searches, click the "Apply for Search" button to submit your resume for consideration.

Company
Carrier-owned Service Company

Description
This position is highly visible internally to Senior Management. Determine all functions required to move Utilization Review in-house. Interact with Software vendor. Manage migration of tasks to an internal team. Staffing: hire, train, mentor, and terminate, as required. Manage processes. Insure accurate review of UR cases based on jurisdiction. Insure proper usage of Peer Review Physicians. Insure accurate billing of cases. Recruit Peer Review Physicians as necessary. Interact with clients (internal and external) as necessary, answering questions or researching for answers. Interact with Texas Department of Insurance and other States' Insurance Departments, including the Divisions of Workers Compensation. Create reports, as necessary. Contribute to the success of the business through involvement in sales activities, and interaction with clients, potential clients, and Legislative Agencies.

Qualifications
5+ years Utilization Review experience, and 3+ years management experience. Multi-State Utilization Review experience. Prior experience implementing new programs, preferred. Management of staff including Performance Reviews, and Provider Recruitment. Mitchell International’s ReviewStat software experience preferred. Expertise in Texas Workers’ Compensation Rules and Regulations, Texas Insurance Code. Technology skills including MS Word, Excel. Talent assessment, hiring, and training. Provider recruiting. Use of analytics for trending assessments. College graduate, Texas Nursing License, other State Nursing License highly valued.

Location
Dallas, Texas area

Compensation
Compensation includes a base salary, and benefits.