- Elevance Health (Houston, TX)
- …outpatient precertification, prior authorization, and post service requests. + Refers cases requiring clinical review to a Nurse reviewer. + Responsible for the ... I** will be responsible for coordinating cases for precertification and prior authorization review . **How you will make an impact:** + Managing incoming calls or… more
- Parexel (Austin, TX)
- …by providing client liaison and proposals input. **Key Accountabilities** : **Author Clinical Documents** + Gather, review , analyze, and evaluate pertinent ... will research, create, and edit all documents associated with clinical research. The Senior Medical Writer may operate as...writing deliverable. + Revise document drafts based on the review comments from team members to ensure inclusion of… more
- Houston Methodist (Houston, TX)
- …care reviews, decisions, and other pertinent information per hospital/case management and clinical documentation policies policy. + Review issues identified by ... and CMS regulations, DNV requirements, and guidelines on case management, utilization review , and clinical documentation. + Provide ongoing education to… more
- Aspen Dental (Abilene, TX)
- …the direction of the Manager, supervise and reinforce the daily tasks and priorities of the non- clinical team + Review data day to day to evaluate the impact on ... patient care + Consult with patients on treatment options provided by clinical team, verifying insurance payment and collection ensuring high quality of care… more
- Humana (Austin, TX)
- …all relevant coding. Applies clinical and coding experience to conduct a clinical validation review of the inpatient medical record to validate billed ... and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis coding… more
- UT Health San Antonio (San Antonio, TX)
- …job description is subject to change to meet the OTD Program education/ clinical /administrative standards. Review of applications will begin immediately, and the ... one unified institution, establishing a world-class university integrating academic, research, and clinical aspects. Driven by a vision for growth and impact, this… more
- Humana (Austin, TX)
- …caring community and help us put health first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals (Part D & B). The Medical ... CMS-recognized Compendia, NCCN, Humana Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part… more
- MD Anderson Cancer Center (Houston, TX)
- …agencies as specified in the reporting requirements. Direct support to clinical trial research protocols. Review protocol documents including abstracts, ... of cancer. *The ideal candidate will have prior experience, as Research Nurse, with clinical trials in Radiation Therapy, Neurology or Oncology. Phase 1 clinical … more
- Ascension Health (Kyle, TX)
- …cost analysis, benchmark data report preparation, trauma registry report preparation and clinical indicators review . + Coordinate and direct activities of the ... and develop community trauma preventions programs, community offerings and clinical education activities. **Requirements** Licensure / Certification / Registration:… more
- MD Anderson Cancer Center (Houston, TX)
- …image segmentation, image processing, dosimetric analyses, machine learning, toxicity assessment, clinical data review , and/or dental science components. 3. ... radiation therapy, and integration of novel research developments with clinical applications. The post-doctoral fellow will assist the principal investigator… more