- Evolent (Austin, TX)
- …Proficiency . Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...rationale for standard and expedited appeals. . Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- Evolent (Austin, TX)
- …Proficiency + Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as ... **Your Future Evolves Here** Evolent partners with health plans and providers to achieve better outcomes...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- Catholic Health Initiatives (Houston, TX)
- …Skills, Abilities and Training: * Comprehensive knowledge of utilization management, Medicare , Medicaid, and commercial admission and review requirements. * ... Required Education and Experience: * Bachelor's degree in Nursing, Health Care Administration or related clinical field * Minimum...in the Texas Medical Center, the hospital is the home of the Texas Heart(R) Institute, a cardiovascular research… more
- Catholic Health Initiatives (College Station, TX)
- …obtaining pre-certification reference number, approved length of stay, and utilization review company contact person and telephone number 13. Notify hospital Case ... regarding insurance plan changes/COB order, out of network plans, and Medicare supplemental plans that require pre-certification 14. Contact physician's on scheduled… more
- CenterWell (Dallas, TX)
- …largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is ... part of our caring community and help us put health first** The Market CMO serves as a ...+ Develop, implement and monitor the outcomes of utilization review and disease management programs to meet the quality… more
- HCA Healthcare (Dallas, TX)
- …**Benefits** Medical City Healthcare, offers a total rewards package that supports the health , life, career and retirement of our colleagues. The available plans and ... cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.… more
- Fresenius Medical Center (San Angelo, TX)
- …logs as directed and applicable + Support patient registration and use of connected health + Provide patient home support as indicated and permissible under ... **PURPOSE** **AND** **SCOPE:** Functions as part of the dialysis health care team in providing safe and effective dialysis therapy for patients under the direct… more
- Kelsey-Seybold Clinic (Stafford, TX)
- …within the palliative care services team to improve quality of life and health for patients with complex chronic illnesses and approaching end-of-life illnesses. + ... Care services to group physicians + Monitor and supervise Supportive Medicine home care delivery team(s) + Facilitate clarification of patient and family goals… more
- Molina Healthcare (Austin, TX)
- … Medicare . **PREFERRED EDUCATION:** Master's in Business Administration, Public Health , Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… more
- Fresenius Medical Center (Dallas, TX)
- …all regulatory and FMS policy requirements. Functions as part of the hemodialysis health care team in providing safe and effective dialysis therapy for patients ... manner. **PRINCIPAL RESPONSIBILITIES AND DUTIES** PATIENT CARE: + Assist other health care members in providing patient specific detailed education regarding… more