- CVS Health (Austin, TX)
- …enhance a member's overall wellness through integration. - Through the use of clinical tools and information/ data review, conducts an evaluation of member's ... This role is a blended role doing both Case Management and Utilization Management . The RN Case...smooth transition to Aetna programs and plans. - Applies clinical judgment to the incorporation of strategies designed to… more
- Veterans Affairs, Veterans Health Administration (Dallas, TX)
- …and rearranges patient priorities to accommodate them. Screens requests for proper clinical history and pertinent data . Modifies the examination to match ... System. Participates in the evaluation, analysis, and formulation of radiographic image management . Evaluates the nature of critical and emergency procedures… more
- Houston Methodist (Houston, TX)
- …**LICENSES AND CERTIFICATIONS** **Required** **Preferred** + CCMA - Certified Contract Management Associate (NCMA) **SKILLS AND ABILITIES** + Demonstrates the ... with both internal and external stakeholders including hospital administration, clinical teams, Legal, Value Analysis, Group Purchasing Organizations (GPO), and… more
- CenterWell (Austin, TX)
- …of clinical and regulatory integrity and compliance. Manages the Denials Management data analytics, denial and appeal process. The Director, Home Health ... application of regulations and performance improvement standards + Strong Project management principles and clinical policy development/implementation required +… more
- Ascension Health (Austin, TX)
- …+ Evaluate risk management functions and process through the use of data capture, follow up and trend analysis and present findings to appropriate committees; ... or management experience preferred. **Additional Preferences** + Emergency Services Clinical Background strongly preferred + Leadership and Risk Management … more
- HCA Healthcare (San Antonio, TX)
- …and programming CIED's following established clinic protocols. + Analyze clinical data and compose written CIED management summaries, clinic visit notes, and ... specialized skill set and will provide both technical and clinical component to ensure the patient care meets established...The Device RN will be independently accountable for the management and coordination of care of patients with devices… more
- Texas A&M University System (Dallas, TX)
- …community-engaged research and evaluation projects, specifically research management , data collection and/or experience with implementation of clinical ... of community-engaged health interventions and/or scientific publications. + Assist with data management and analysis (qualitative and quantitative), including … more
- Datavant (Austin, TX)
- … staff to enhance documentation. + Communicate effectively with co-workers, management , and hospital staff regarding clinical and reimbursement issues. ... Datavant is a data platform company and the world's leader in...compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations reviews. In this role,… more
- CenterWell (Austin, TX)
- …patient base growth, achievement of key performance indicators, and people management /development. The Branch Director supervises the branch/ clinical staff. ... all patients served by the Branch by providing supervision and support to the Clinical Manager(s). + Works in conjunction with the Area Director of Operations or the… more
- Humana (Austin, TX)
- …of the managed care industry, Integrated Delivery Systems, health insurance, or clinical group practice management + Utilization management experience ... put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D...to complex issues where the analysis of situations or data requires a case by case consideration of the… more