- Houston Methodist (Katy, TX)
- …The Patient Access Center Representative position also assists management with auditing/ quality review to ensure accurate and appropriate scheduling and ... variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care. Houston Methodist is an… 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 ... Director, MSK Surgery you will be a specialty match reviewer for Spine Surgery cases. you will be a...Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines. + Aids and acts as… more
- Baylor Scott & White Health (Dallas, TX)
- …vary based on position type and/or level **Job Summary** + You will review patient cases for medical necessity and establish service suitability. You'll educate the ... plan and the provider's care coordination departments. Your expertise is needed to review medical necessity. + Working with the team, you'll verify medical records… more
- Molina Healthcare (Houston, TX)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (Dallas, TX)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Molina Healthcare (Houston, TX)
- …HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- Houston Methodist (Houston, TX)
- …considerable complexity for the Department of Legal Services, with a focus on review , drafting, negotiation, and execution of Clinical Trial Agreement ("CTA," ... attorneys in the Department of Legal Services with contract review for CTA agreements for the Houston Methodist Research...that operate at the system level to help enable clinical departments to provide high quality patient… more
- UT Health San Antonio (San Antonio, TX)
- …and their personnel . Review FRO patient care reports to ensure quality control and clinical accuracy . Ensure compliance with Texas Department of ... Antonio invites applications for a full-time, twelve-month Lecturer, Assistant Professor/ clinical , or Associate Professor/ clinical faculty position. The position… more
- Houston Methodist (Houston, TX)
- …The Patient Access Center Representative position also assists management with auditing/ quality review to ensure accurate and appropriate scheduling and ... variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care. Houston Methodist is an… more
- Houston Methodist (Katy, TX)
- …suggestions for process improvement. This position also assists management with auditing/ quality review to ensure accurate and appropriate scheduling and ... variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care. Houston Methodist is an… more