- CVS Health (Austin, TX)
- …consistent responses to members and providers related to precertification, concurrent review , and appeal request. This position is primarily responsible for ... including prior authorization and precertification as well as concurrent review . Cases could focus on inpatient or outpatient, acute...inpatient or outpatient, acute and post-acute as well as peer to peer calls and first level… more
- Houston Methodist (Houston, TX)
- …organizational resources. In addition, this position is responsible for the review , acquisition, implementation, and monitoring of new technologies that are deployed ... competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees,… more
- Houston Methodist (Houston, TX)
- …competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, ... and improving the department workflow and enhancing operations, using peer -to- peer accountability and identifying solutions via collaboration. Implements… more
- Houston Methodist (Katy, TX)
- …competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, ... of safe outcomes by monitoring and improving the department workflow, using peer -to- peer accountability, reporting accidents, near misses, and/or adverse events… more
- Molina Healthcare (Fort Worth, TX)
- …in the team and across the enterprise.* Leads architectural committees and peer group discussions in adherence to industry standards. + Leads solution architecture ... reviews and approvals as part of the Architecture Review Board (ARB) function for Data Lakehouse platforms across the enterprise.* Responsible to support the… more
- Houston Methodist (The Woodlands, TX)
- …for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use, ... focus given to discharge plan and elimination of barriers. + Performs post-discharge review by analyzing the inpatient record to ensure that compliance with quality… more
- Houston Methodist (Houston, TX)
- …guidance, policy and procedure developed by Houston Methodist Research Institute Institutional Review Board (IRB), Food and Drug Administration (FDA) Code of Federal ... with key study personnel. + Acts as a liaison between the institutional review committees, regulatory agencies, and the investigators to ensure that protocols are… more
- Houston Methodist (Houston, TX)
- …proposal data, management of prospect and donor portfolios, and facilitation of review sessions that result in strategies and activities that successfully move ... competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees,… more
- Houston Methodist (The Woodlands, TX)
- …competent and engaged employee group by conducting regular department meetings to review policies and procedures and operational matters, rounding on all employees, ... of safe outcomes by monitoring and improving the department workflow, using peer -to- peer accountability, reporting near misses and/or adverse events immediately… more
- Evolent (Austin, TX)
- …reviews to be completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting physicians or ordering providers, ... provides clinical rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD … more