- CenterWell (Eastland, TX)
- … of clinical documentation in addition to feedback and recommendations by Utilization Review staff. Upon completion of the assessment, creates and conducts ... caring community and help us put health first** The ** Clinical Manager** coordinates and oversees all direct care...requirements. + Responsible for the QA/PI activities. Works with Utilization Review staff relative to data tracking… more
- Houston Methodist (Houston, TX)
- …patient care activities and patient outcomes as impacted by pharmaceutical care and clinical interventions. + Participates in department quality management ... areas of the department which includes processing orders, therapy review , and education to patients and other members of...to patients and other members of the direct patient care team. This position collaborates with other health … more
- CVS Health (Arlington, TX)
- …+ Field Experience. + Bilingual. + Crisis intervention skills preferred. + Managed care / utilization review experience preferred. + Case management and ... cost-effective outcomes. **Assessment of Members:** + Through the use of clinical tools and information/data review , conducts comprehensive assessments of… more
- MD Anderson Cancer Center (Houston, TX)
- …Houston is one of the world's most respected centers focused on cancer patient care , research, education and prevention. It was named the nation's No. 1 hospital for ... cancer care in US News & World Report's 2024-2025 rankings....reports quality improvement data in a format that facilitates review by the division CQI committee. * Maintains knowledge… more
- HCA Healthcare (Dallas, TX)
- …benefits may vary by location._** Come join our team as a Division Director of Clinical Informatics. We care for our communities and employees! HCA Hope Fund in ... the electronic health record (EHR) including: 1. standardization 2. utilization 3. integration 4. optimization The DCI is responsible...**Experience:** + Minimum of 3 to 5 years of clinical experience in an acute care hospital… more
- Molina Healthcare (TX)
- …Experience** Previous experience in Hospital Acute Care , ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual / ... team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care , for… more
- Evolent (Austin, TX)
- …Provides clinical rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the MD ... and costly health conditions. Working across specialties and primary care , we seek to connect the pieces of fragmented... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Molina Healthcare (San Antonio, TX)
- … Care Experience in the specific programs supported by the plan such as Utilization Review , Medical Claims Review , Long Term Service and Support, or ... Officer during Fair Hearings as may be required. + Serves as a clinical resource for Utilization Management, Chief Medical Officer, Physicians, and… more
- HCA Healthcare (Dallas, TX)
- …with the development, implementation, and monitoring of pharmacy operations initiatives (operational/ clinical ) + Participates in the development and review of ... you find this opportunity compelling, we encourage you to apply for our Clinical Pharmacist Specialist BMT opening. We promptly review all applications. Highly… more
- Erickson Living (Houston, TX)
- …+ Participating in clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk ... How you will make an impact + Coordinating, implementing, and overseeing the clinical care of guests/residents in skilled nursing/long-term care … more