- CenterWell (Austin, TX)
- … clinical RN experience; + Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + ... and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that… more
- Molina Healthcare (TX)
- …field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or ... LPCC or LMFT (for Behavioral Health Care Review Clinicians only). **Preferred Experience** 3-5 years clinical...Experience** 3-5 years clinical practice with managed care , hospital nursing or utilization management experience.… more
- BAYADA Home Health Care (Austin, TX)
- …company match, direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and accuracy ... is no flexibility around this requirement.** BAYADA Home Health Care has an immediate opening for a **Full Time,**...an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance,… more
- BAYADA Home Health Care (Austin, TX)
- …about BAYADA Benefits, click here (https://www.bayada.com/benefits/) . **Responsibilities:** + Review clinical information for appropriateness, congruency, and ... is no flexibility around this requirement.** BAYADA Home Health Care is hiring a full time OASIS Review...should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance,… more
- Actalent (Dallas, TX)
- Clinical Review Nurse ( Utilization ... care . Essential Skills + 2+ years of utilization management and utilization review ... member. Responsibilities + Perform concurrent reviews to assess member's overall health. + Review the type of care being delivered and evaluate medical… more
- CenterWell (Fort Worth, TX)
- …experience, quality of care , clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in care ... determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization *Monitor and manage daily patient care and initiatives to… more
- CenterWell (Arlington, TX)
- …patient experience, quality of care , clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities in ... determinants of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and initiatives to… more
- HCA Healthcare (Live Oak, TX)
- …we encourage you to apply for our Advanced Clinical Pharmacist Critical Care opening. We promptly review all applications. Highly qualified candidates will ... like family! Jump-start your career as an Advanced Clinical Pharmacist Critical Care today with Methodist...participating in daily multidisciplinary and bedside rounds, completing drug utilization review to promote rational drug therapy,… more
- Evolent (Austin, TX)
- …you ready to make a meaningful impact on patient care in a non- clinical setting? Join our Utilization Management team as a Field Medical Director, ... when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the… more
- HCA Healthcare (Kingwood, TX)
- …Me About the SOB!** **Introduction** Do you have the career opportunities as a(an) Clinical Pharmacist - Critical Care you want with your current employer? We ... knowledge and expertise! **Job Summary and Qualifications** As a Clinical Pharmacist - Critical Care , you will...personal growth, we encourage you to apply for our Clinical Pharmacist opening. We promptly review all… more