- Evolent (Austin, TX)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. . Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. . Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Austin, TX)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- HCA Healthcare (San Antonio, TX)
- …senior-level leadership to the infection control, risk management, safety, and medical staff credentialing functions, ensuring the collaboration and coordination ... to improve the functionality and effectiveness of the hospital medical staff organization. + Partners with ...and quality profiling. Serves as a member of hospital's peer review committees as requested. Business Development… more
- Evolent (Austin, TX)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...expedited appeals. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Austin, TX)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Houston Methodist (Houston, TX)
- …certifications + Ability to establish and maintain effective working relationships with patients, medical staff , co-workers and the public + Ability to work with ... oversight for documentation of vital signs, chief complaint(s), preforms medication(s) review , and discusses/reviews medical and social history (as appropriate).… more
- CVS Health (TX)
- …Texas. The Medical Director is part of a centralized team that supports the Medical Management staff and may support other health plans as needed. The ... focus on inpatient or outpatient, acute and post-acute as well as peer to peer calls and first level appeals. The Medical Director participates in a rotating… more
- MD Anderson Cancer Center (Houston, TX)
- …Department of Melanoma Medical Oncology for all faculty, fellows, residents, students, and staff . i. Provide peer review for assessing the clinical and ... The Department of Melanoma Medical Oncology (MMO) at The University of MD...assistant, associate, or full professor. MMO includes faculty and staff involved in patient care and clinical, translational, and… more
- Elevance Health (Grand Prairie, TX)
- …for employment, unless an accommodation is granted as required by law. The ** Medical Director-Dermatology Appeals** is responsible for the review of appeals for ... of care opportunities. May serve as a resource to staff including Medical Director Associates. May be...clinical operational aspects of a program. + May conduct peer -to- peer clinical reviews with attending physicians or… more
- MD Anderson Cancer Center (Houston, TX)
- …for information, and interviewing patients/families for information. Collaborates with the medical staff , research nurses, and other health professionals to ... and communicates pertinent clinical information based on physical examination and review of patient data. Manages daily patient problems and emergency situations… more