- Baylor Scott & White Health (Waco, TX)
- …resources to reduce unnecessary utilization. **Location: Waco, TX -** **100 Hillcrest Medical Blvd, Waco, 76712** **Setting: Case Management - Emergency Dept** ... continuum, utilizing accepted criteria and guidelines to manage benefits and determine medical necessity of services provided. This position will function as a… more
- ZOLL Medical Corporation (Houston, TX)
- …innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and ... as well as support activities to promote consistent use (Local Medical Education Programs, Tradeshows, clinical symposiums and conferences). Call points include:… more
- Catholic Health Initiatives (Bryan, TX)
- …of care and discharge planning Communicates treatment plan with collaborative team members - medical , nursing, PT, OT, SW, Case Manager Monitors patient for ECG ... through reports on improved patient outcomes, length of stay, and cost per case for this patient population Validate staff understanding and adherence to patient… more
- Datavant (Austin, TX)
- …for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to ... ICD-10-CM and ICD-10-PCS codes + Accurately sequence and abstract medical codes from patient records, ensuring precision and adherence...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Humana (Austin, TX)
- …a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare, Medicare Advantage, and Medicaid requirements… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- Highmark Health (Austin, TX)
- …current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and ... of the requested treatment of service. Depending on the nature of the case , telephonic peer to peer discussions may be required. The incumbent ensures compliance… more
- Humana (Austin, TX)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... of situations or data requires an in-depth evaluation of variable factors. The Medical Director actively uses their medical background, experience, and judgement… more
- Elevance Health (Houston, TX)
- ** Medical Management Nurse** **Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training ... members in different states; therefore, Multi-State Licensure will be required.** The ** Medical Management Nurse** is responsible for review of the most complex or… more
- Zurich NA (Houston, TX)
- Medical Assistance Coordinator 119446 **Let's grow together!** Zurich Cover-More is one of the world's largest travel insurance and assistance providers and part of ... companies, major banks and credit card providers and leading retailers. Our Medical Assistance Center coordinates and provides support to multiple lines of business… more