- Molina Healthcare (Fort Worth, TX)
- … Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, or ... the state they reside This position will support Medical Review for Medicare and Marketplace request authorization. Strongly prefer...of service provided, length of stay and level of care . + Applies appropriate criteria on PAR and Non-PAR… more
- HCA Healthcare (Dallas, TX)
- …staff committees as necessary. + Assists with staff performance evaluations. + Acts as manager in charge as assigned. + Provides review and guidance on physician ... team. Grow your career with an organization committed to delivering respectful, compassionate care , and where the unique and intrinsic worth of each individual is… more
- Elevance Health (Grand Prairie, TX)
- …on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
- Elevance Health (Houston, TX)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... health medical services, to ensure the appropriate and most cost-effective medical care is received. May be responsible for developing and implementing programs to… more
- CenterWell (Fort Worth, TX)
- …in patient experience, quality of care , clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... and social determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to… more
- CenterWell (Arlington, TX)
- …in patient experience, quality of care , clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to align with… more
- KBR (Houston, TX)
- …as assigned by the HP program Manager and/or Coordinator. + Document care provided, work performed, utilization , referrals, and all other information in ... scope of practice. + Participate in periodic meetings to review the care provided to patients and...+ Serve as an advisor to the HP program Manager and/or Coordinator in matters related to injury prevention,… more
- Veterans Affairs, Veterans Health Administration (Abilene, TX)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities VA Careers - Social Work: ... of performance improvement measures directly effecting the HUD/VASH program, voucher utilization and outreach measures. actively participates in program planning and… more
- HCA Healthcare (Fort Worth, TX)
- …auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling ... with Progyny and adoption assistance. + Referral services for child, elder and pet care , home and auto repair, event planning and more + Consumer discounts through… more
- Select Medical (Fort Worth, TX)
- …the staff in the use of the nursing process and in the development and utilization of the interdisciplinary care plan for all patients. Assesses and makes ... nursing staff work loads. + Collaborates with the Chief Nursing Officer/Nurse Manager /House Supervisor to ensure continuity of care over twenty-four hours.… more