- Evolent (Austin, TX)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Clinical Reviewer , Physical Therapy As a Clinical Reviewer , ... health outcomes. **Collaboration Opportunities: ** + Functions in a clinical review capacity to evaluate all cases,...that an approval cannot be rendered to the Physician Clinical Reviewer . In States where allowed, will… more
- Elevance Health (Grand Prairie, TX)
- **Nurse Reviewer I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... employment, unless an accommodation is granted as required by law. The **Nurse Reviewer I** will be responsible for conducting preauthorization, out of network and… more
- HCA Healthcare (Pasadena, TX)
- …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 to $300 million in ... We are looking for a dedicated Coding Quality Audit Reviewer like you to be a part of our...result in appropriate reimbursement and data integrity. You will review outcomes are communicated to the HSC team to… more
- TEKsystems (Austin, TX)
- Description + Review and audit chemotherapy regimens for medical necessity and pathway adherence. + Communicate insurance requirements to clinical staff and ... resolve documentation or coverage issues. + Maintain and update coding and payer guidelines. + Obtain authorizations and act as a liaison between patients and payers. + Research alternative resources for non-covered services and provide community support… 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, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
- Texas Health Resources (Arlington, TX)
- Director Utilization Management- Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... Bachelor's Degree Nursing required Master's Degree preferred Experience 3 years clinical experience in an acute hospital setting required 3 years Utilization… more
- MD Anderson Cancer Center (Houston, TX)
- *Position Title: *Assistant Professor, Clinical Faculty Appointment *Department: *AnatomicPathology *Division: *Pathology & Laboratory Medicine *Reports to: ... in subspecialty rotations(s), and (b) to develop and implement basic or clinical and translational research in the subspecialty field of surgical pathology… more
- UTMB Health (Galveston, TX)
- Assistant Professor Clinical Practice - Family Medicine **Galveston, Texas, United States** **New** Faculty UTMB Health Requisition # 2505500 **Family Medicine ... Opportunity** **Associate/Full Professor of Family Medicine** ** Clinical Trials Researcher, Sealy Institute for Vaccine Sciences** **University of Texas Medical… more
- InGenesis (El Paso, TX)
- InGenesis is seeking a Clinical Director to work with our potential client. In this role, you will oversee the delivery of healthcare services at facilities staffed ... all aspects of healthcare delivery at the assigned facility. * Clinical supervisory authority over advanced practice providers (APPs), nursing staff, pharmacists,… more
- MD Anderson Cancer Center (Houston, TX)
- …patients by phone conversations or in writing to other physicians. * Provide peer review for assessing the clinical practice of faculty within the department. * ... *Administrative and Service: * * Participate in investigation and review of best practice initiatives and clinical ...and review of best practice initiatives and clinical and institutional effectiveness projects. * Serve on institutional… more