- Elevance Health (Houston, TX)
- …must be located in a state or territory of the United States when conducting utilization review or an appeals consideration and cannot be located on a US ... ** Medical Director** _Please note that per our policy...reviews with attending physicians or other providers to discuss review determinations, and patients' office visits with providers and… more
- San Antonio Behavioral Health (San Antonio, TX)
- The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... status of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of… more
- CenterWell (Fort Worth, TX)
- …in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify opportunities in ... part of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team,… more
- CenterWell (Arlington, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify opportunities ... community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of...of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and… more
- Veterans Affairs, Veterans Health Administration (Houston, TX)
- …coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules ... Summary This Medical Support Assistant (Advanced), also referred to as...patients with third-party insurance. Promotes Veteran registration for and utilization of My HealtheVet (MHV); Schedules Veteran appointments with… more
- Catholic Health Initiatives (Houston, TX)
- **Responsibilities** The Market/ Baylor St. Luke's Medical Center Chief Medical Officer (MCMO) for the Houston market is a senior-level leadership position with ... Market President with matrix reporting to the Region Chief Medical Officer (RCMO). The MCMO has a dyad relationship...market MSO director to lead credentialing, privileging, and peer review . + Set strategic direction for the areas mentioned… more
- Travelers Insurance Company (Austin, TX)
- …influences which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State ... regulations and medical guidelines to establish medical ...Have?** + Licensed MD + 5 years clinical and utilization management experience + Certified by the American Board… more
- Houston Methodist (The Woodlands, TX)
- …procedures related to quality and patient safety. + Serves as liaison with medical staff to assure appropriate utilization of hospital services/resources and as ... Outcomes and collaborates with all disciplines, hospital leadership, and the medical staff to promote identification of organizational vulnerabilities, health care… more
- MD Anderson Cancer Center (Houston, TX)
- …systems to obtain patient information, print patient schedules, order diagnostic tests, review medical history, and assists with the efficiency of room ... and the public. *SUMMARY* The primary purpose of the Medical Assistant position is to act as a lead...to obtain vital signs, limited patient histories, and medication review based on established Diagnostic Imaging standard operating procedures… more
- Molina Healthcare (San Antonio, TX)
- …administrative incentives + Supervises and manages Medical Directors + Develops medical policies and procedures + Conducts peer review **JOB QUALIFICATIONS** ... 3+ years HMO/Managed Care experience **OR** 5 years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management +… more