- Molina Healthcare (Houston, TX)
- …in healthcare provider engagement or payer-provider program management. + Familiarity with clinical , quality , or risk adjustment program workflows. + Proficiency ... Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program management, operational execution, and provider… more
- Houston Methodist (Houston, TX)
- …for for investigating products, procedures or processes that will improve operational and clinical efficiency, increase the quality of patient care and reduce ... identified by stakeholders. + Supports the hospital and system quality intiatives through effective review and implementation...that operate at the system level to help enable clinical departments to provide high quality patient… more
- CommonSpirit Health at Home (Houston, TX)
- …and direction of clinical services provided. Oversees the coordination, continuity, and quality of clinical care as well as the supervision of client ... of quality care. Monitors, evaluates, and takes action on clinical measures of performance. Has responsibility for performance, development and coaching of… more
- Evolent (Austin, TX)
- …mission. Join a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer , Nurse, you will be a key member of the utilization management ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse, you will routinely interact...**What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases,… more
- Evolent (Austin, TX)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer , Nurse, you will be a key member of the utilization management ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse, you will routinely interact...**What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases,… more
- San Antonio Behavioral Health (San Antonio, TX)
- …are utilized; developing new models of treatment . Monitors regulatory and clinical standards; productivity and quality assurance efforts, meet contractual ... The Clinical Services Director oversees inpatient clinical ...be primarily responsible for overseeing the operational efficiency and quality of clinic services, including direct supervision of licensed… more
- Elevance Health (Grand Prairie, TX)
- …state(s). + Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years ... **Diagnosis Related Group Clinical Validation Auditor-RN** **Virtual:** This role enables associates...the conditions and DRGs billed and reimbursed. Specializes in review of Diagnosis Related Group (DRG) paid claims. **How… more
- Sam Houston State University (Huntsville, TX)
- …and papers; supervising independent study projects and supervising or teaching clinical internships or programs. Professional peer review and professional ... interact both on campus and within the clinical sites. Clinical Care - provide high quality patient care to the community in support of the SHSU Physician's… more
- HCA Healthcare (Brownsville, TX)
- …Do you want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. HCA Healthcare has committed up ... a difference. We are looking for a dedicated Coding Quality Audit Reviewer like you to be...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
- Kelly Services (Houston, TX)
- Quality Control Microbiology Specialist Kelly science & Clinical is seeking a Quality Control Microbiology Specialist to join our client's QC team. As the QC ... in support of EM and/or bioburden/sterility testing. * Draft and review SOPs, protocols, reports, environmental monitoring excursions, OOS investigations, and other… more