- HCA Healthcare (Houston, TX)
- …Under the general supervision of the Director of Laboratory or designee, provides clinical laboratory services and monitors point of care (POC) testing accuracy ... of the Medical Staff and other Hospital Departments to enhance patient care services. + Coordinates clinical laboratory service scheduling with applicable… more
- CVS Health (Austin, TX)
- …and providers. As a Medical Director you will focus primarily on overseeing utilization review / quality assurance and be responsible for predetermination ... transparent and consumer-focused, and it recognizes physicians for their clinical quality and effective use of health care... clinical quality and effective use of health care resources. This is a remote based (work from… more
- Houston Methodist (Sugar Land, TX)
- … clinical operational indicators including quality metrics such as in basket utilization , clinical close rate, etc. Assesses current performance and develops ... position is responsible for independently managing and/or coordinating complex delivery of care within a large, multi-physician primary care , specialty, or… more
- CVS Health (Austin, TX)
- …transferring patients to lower levels of care . + 1+ years' experience in Utilization Review . + CCM and/or other URAC recognized accreditation preferred. + 1+ ... self-insured clients. + Application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures… more
- CVS Health (Austin, TX)
- …Plus **Preferred Qualifications:** -Health plan/payor Utilization Management / Review experience -Electronic medical systems/record experience -Managed Care ... responses to members and providers related to precertification, concurrent review , and appeal request. This position is primarily responsible...- Five or more years of experience in Health Care Delivery System eg, Clinical Practice and… more
- Select Medical (Frisco, TX)
- …+ Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator, etc., to assure positive fiscal ... planning process. **The primary job functions in Case Management include:** + Clinical Interventions/Discharge and Care Planning Management + Fiscal Management +… more
- Veterans Affairs, Veterans Health Administration (El Paso, TX)
- …by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Responsibilities Total Rewards of a Allied Health ... to track service activities including visits, referrals, demographics, equipment utilization and Veteran satisfaction. Advising and collaborating with interdisciplinary… more
- HCA Healthcare (San Antonio, TX)
- …Bachelor of Science in Nursing + At least one year experience in utilization review , resource management, discharge planning or case management. Prior Case ... care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of...setting is a plus. + Minimum of 3 years clinical RN Experience in acute setting. + RN License… more
- Baylor Scott & White Health (Temple, TX)
- … and pharmacy benefit management. This includes prescription drugs, benefits design, utilization review , formulary management, and cost containment strategies. + ... include service efficiencies, process standardization, drug formulary, and drug utilization . It also involves vendor selection, productivity, performance standards,… more
- ChenMed (Houston, TX)
- …and explain nurse practitioner role. + Facilitates patient/family conferences to review treatment goals, optimize resource utilization , provide family education ... your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great...The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct… more