- Humana (Austin, TX)
- …clinical group practice management. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed ... **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 … more
- Molina Healthcare (San Antonio, TX)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... Utilization/Quality Program management + Previous leadership experience + Peer review , medical policy/procedure development, and provider contracting experience… more
- Molina Healthcare (Austin, TX)
- …Public Health, Healthcare Administration, etc. **PREFERRED EXPERIENCE:** + Peer Review , medical policy/procedure development, provider contracting experience. + ... Summary** Responsible for serving as the primary liaison between administration and medical staff. Assures the ongoing development and implementation of policies and… more
- Houston Methodist (Houston, TX)
- …team. + Functions as a resource to department staff in communicating medical information required by external review entities, managed care contractors, ... At Houston Methodist, the Sr Utilization Review Specialist Nurse (URSN) position is a licensed...As a full-service, acute-care hospital located in the Texas Medical Center and the flagship hospital of Houston Methodist,… more
- ProSphere Tek (Conroe, TX)
- …documentation requirements, time requirements, functions, and workflow to process electronic medical records, to review records for accuracy and completeness, ... Planned Systems International (PSI) joint venture, is seeking a Medical Records Technician to support the ICE Health Services...for Cognito, you will utilize your abilities as a Medical Records Technician to provide the safe delivery of… more
- Humana (Austin, TX)
- …help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health claims and preservice appeals. The Corporate ... diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions regarding the… more
- Houston Methodist (Houston, TX)
- …study budgets, coverage analyses, etc. - Performs detailed claims testing and medical review . - Reviews Medicare Coverage Analysis to ensure completion ... + Provides oversight and performs detailed claims analysis and medical record review as necessary, including the following: - Assessment of documents,… more
- Select Medical (Lakeway, TX)
- …of medical rehabilitation. They assess patients to determine individual care needs, review medical records and meet with hospital teams to coordinate safe ... Scott & White Institute for Rehabilitation - Lakeway** A joint venture with Select Medical & Baylor Scott & White Health Lakeway, TX _Recognized as a Top Workplace… more
- Select Medical (Lakeway, TX)
- …of medical rehabilitation. They assess patients to determine individual care needs, review medical records and meet with hospital teams to coordinate safe ... Scott & White Institute for Rehabilitation - Lakeway** A joint venture with Select Medical & Baylor Scott & White Health Lakeway, TX _Recognized as a Top Workplace… more
- Select Medical (Denton, TX)
- …of medical rehabilitation. They assess patients to determine individual care needs, review medical records, and meet with hospital teams to coordinate safe ... a healthy work-life balance + **Your Health Matters** : Comprehensive medical /RX, health, vision, employee assistance program (EAP) and dental plan offerings… more