Quality Utilization & Case Review Specialist

Texas Family Care Network

Texas Family Care Network is seeking an Utilization Management & Case Review Specialist to conduct utilization reviews, case record reviews, and quality assessments supporting compliance and service quality. You will analyze utilization patterns, review documentation for accuracy, identify risks, and collaborate with providers to drive continuous improvement.

Responsibilities include monitoring service trends, ensuring alignment with contracts, applying review tools, and supporting audits.

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Vacancy posted 4 days ago

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