- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators and criteria as approved by medical staff,… more
- The Hartford (San Antonio, TX)
- …accomplish theirs, too. Join our team as we help shape the future. The Specialist role of Workers Compensation, Major Case Unit will manage the investigation, ... Specialist Claims - CH07DE We're determined to make a difference...be a part of a team of 4 -5 Major Case Unit Claim Specialists as well as a Home Office… more
- Travelers Insurance Company (Houston, TX)
- …and serves as an expert technical resource to other claim professionals, business partners, customers, and other stakeholders as appropriate or required. This ... of policy information to facts or allegations of each case . + Consult with Manager on use of Claim...on severity/complexity protocols, that should be transferred to another level of claim professional and refer on a timely… more
- Molina Healthcare (Austin, TX)
- **Job Description** **Job Summary** The Sr Specialist , Member & Community Interventions oversees and implements new and existing clinical quality member intervention ... initiatives including all lines of business (Medicare, Marketplace, Medicaid). Executes health plan's member and community quality focused interventions and programs… more
- IBM (Austin, TX)
- …migration, deployment, and adoption of AI and Hybrid Cloud offerings. * Facilitating Use Case Exploration and Business Framing: Lead use case exploration and ... solutions, co-creating with customers, partners, and colleagues to solve technical and business challenges. IBM's Sales Internship Program culture will set you up… more
- Houston Methodist (Sugar Land, TX)
- …to both operational and clinical stakeholders. The Senior Denials Management Specialist position collaborates with physicians, case managers, and payors ... At Houston Methodist, the Senior Denials Management Specialist position is responsible for performing utilization review...appropriate decisions and is accountable for reviewing denials for level of care, medical necessity, and as appropriate, DRG… more
- IBM (Dallas, TX)
- …migration, deployment, and adoption of AI and Hybrid Cloud offerings. * Facilitating Use Case Exploration and Business Framing: Lead use case exploration and ... co-creating with customers, partners, and colleagues to solve technical and business challenges. Excellent onboarding training will set you up for success,… more
- Abbott (Mcallen, TX)
- …for diversity, working mothers, female executives, and scientists. **The Opportunity** Our business purpose is to restore health and improve quality of life through ... The job purpose and scope of the Clinical Sales Specialist (CSS) role is to provide TAVI clinical trial...role is to provide TAVI clinical trial and commercial case support, trial enrollment & education initiatives for accounts… more
- HCA Healthcare (Austin, TX)
- …care like family! Jump-start your career as a(an) Clinical Rehab Specialist today with St. David's Rehabilitation Hospital. **Benefits** St. David's Rehabilitation ... location._** Come join our team as a(an) Clinical Rehab Specialist . We care for our community! Just last year,...acute inpatient rehab operations. You will establish relationships with case managers, payors, and other referral sources. You will… more
- HCA Healthcare (Plano, TX)
- …is recognized. Submit your application for the opportunity below: Assessment Specialist **Benefits** Virtual Patient Logistics Center, offers a total rewards package ... **_Note: Eligibility for benefits may vary by location._** We are seeking an Assessment Specialist for our team to ensure that we continue to provide all patients… more