- Houston Methodist (Houston, TX)
- …key operational indicators including financial and quality metrics eg in basket utilization , clinical close rate, etc. Assesses current performance and develops ... competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees,… more
- Houston Methodist (Houston, TX)
- …This position is responsible for assisting providers in the administration of patient care in assigned clinical areas. The MA position assists with patient ... as well as company policies and procedures. The MA position participates in patient care which is under the direction of a physician and within the scope of… more
- Veterans Affairs, Veterans Health Administration (Kerrville, TX)
- …respond to critical lab/diagnostic test result notifications in a timely manner. - Clinical Management including direct and indirect patient care : ensure all ... for other GEC providers.- Participates in chart reviews, peer review and other process improvement initiatives. The staff will...new focus on the Medical Home and Patient Centric Care , Utilization , Quality and Patient Safety oversight,… more
- San Antonio Behavioral Health (San Antonio, TX)
- …from standards of care . * Maintain accurate and detailed records of utilization review activities and outcomes. * Prepare reports and summaries of findings ... The Utilization Review Coordinator conducts utilization...utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts… more
- Humana (Austin, TX)
- …insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review organization, ... their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical ...region or line of business. The Medical Director conducts Utilization Management of the care received by… more
- Evolent (Austin, TX)
- …the support services review process. Responsible for the quality of utilization review determinations, including appeals. + Provides input into audit ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented...member of the Medical leadership team, providing timely medical review of service requests. Oversees the Surgery Field Medical… more
- Immigration and Customs Enforcement (Los Fresnos, TX)
- …in-person or virtually). Utilizes the electronic medical record (EMR) to complete clinical documentation, and to review and process telephone encounters, etc. ... Health Service Corps (IHSC), Office of the Deputy Assistant Director of Clinical Services, Behavioral Health Unit (BHU). This position is supervisory. This position… more
- Humana (Austin, TX)
- …insurance, other healthcare providers, clinical group practice management + Utilization management experience in a medical management review organization, ... participate in meetings involving care management, provider relations, quality of care , audit, grievance and appeal and policy review . The Behavioral Health… more
- CenterWell (Austin, TX)
- …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed ... a part of our caring community and help us put health first** Utilization Management Administration Coordinator II , non- clinical , supports the UM operations… more
- Houston Methodist (Houston, TX)
- …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs position… more