- Elevance Health (Houston, TX)
- … Director** **Carelon Medical Benefits Management** **Radiology Benefit** **Management/ Utilization ** ** Review ** **Virtual:** This role enables associates to ... decisions. + Brings to their supervisors attention, any case review decisions that require + Medical Director...any case review decisions that require + Medical Director review or policy interpretation. **Minimum… more
- HCA Healthcare (Austin, TX)
- …retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... Summary and Qualifications** Provides overall coordination in the delivery of medical services and discharge planning for specified patient populations. Performs… more
- Molina Healthcare (Houston, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... needed. + Processes requests within required timelines. + Refers appropriate cases to Medical Directors and presents them in a consistent and efficient manner. +… more
- Molina Healthcare (TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- HCA Healthcare (Austin, TX)
- …retrospective review of patient medical records for purposes of utilization review , care coordination compliance with requirements of external review ... and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low… more
- Abbott (Plano, TX)
- …insurance, Worker's Compensation and Medicare guidelines pertaining toProspective and Retrospective Utilization Review . Some experience in medical deviceor ... insurance, Worker's Compensation and Medicare guidelines pertaining to Prospective and Retrospective Utilization Review . + Experience in medical device or… more
- BAYADA Home Health Care (Austin, TX)
- …+ Candidates should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health ... Home Health Care is hiring a full time OASIS Review and Coding Manager. The OASIS and Coding ...Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with… more
- BAYADA Home Health Care (Austin, TX)
- …your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding, ... immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work...Paid holidays, vacation and sick leave, vision, dental and medical health plans, employer paid life insurance, 401k with… more
- Molina Healthcare (Dallas, TX)
- …Experience Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... within required timelines. + Refers appropriate prior authorization requests to Medical Directors. + Requests additional information from members or providers in… more
- Molina Healthcare (San Antonio, TX)
- …stay for requested treatments and/or procedures. * Works collaboratively with the Utilization and Case Management departments to provide ABA/BHT services to Molina ... by reviewing Behavioral Health Therapy (BHT) assessments and treatment plans for medical necessity and BHT best practice guidelines. This includes but is not… more