- BAYADA Home Health Care (Austin, TX)
- …company match, direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and accuracy ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...for this role (Please note, while this is a clinical opening, BAYADA does have non- clinical openings… 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 ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...and meeting business and development goals. This is a **non- clinical ** role (Note: Clinical opportunities are also… more
- Centene Corporation (Austin, TX)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... work PST hours remotely_** + **_Prior authorization or utilization review experience (preferred)_** **Position Purpose:** Analyzes all prior authorization requests… more
- Wolters Kluwer (Dallas, TX)
- … Content Specialist - Nursing, you will work closely with the PreView & ReView Manager/Senior Clinical Content Specialists to plan and deliver high quality NCLEX ... virtually or in person. + Run evaluations, send to facilitator PreView & ReView Content Management Consultant/Senior Clinical Content Specialist and file. +… more
- MD Anderson Cancer Center (Houston, TX)
- …* *Collaboration and Development* . Participates during the pre-submission stage in the clinical review of the upcoming protocols and provides feedback on any ... by the National Cancer Institute. The primary purpose of the Senior Clinical Studies Coordinator position is to provide independent and advanced patient care… more
- Evolent (Austin, TX)
- …staff and Field Medical Directors. **What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not pass the ... record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of… more
- Evolent (Austin, TX)
- …staff and Field Medical Directors. **What You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not pass the ... record documentation in order to approve services that meet clinical review criteria. + Conducts ongoing activities which monitor established quality of… more
- Fresenius Medical Center (Midland, TX)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Molina Healthcare (San Antonio, TX)
- …identified by the Payment Integrity analytical team; requires decision making pertinent to clinical experience + Documents clinical review summaries, bill ... Looking for a RN with experience with appeals, claims review , and medical coding. **Job Summary** Utilizing clinical... review , and medical coding. **Job Summary** Utilizing clinical knowledge and experience, responsible for review … more
- Prime Therapeutics (Austin, TX)
- …using clinical criteria. Makes approval recommendations on all services that meet clinical review criteria. Refers all cases not meeting clinical ... medical exception requests to nurse, pharmacist or physician on the utilization review clinical team when further review is necessary. + Other duties… more