- Elevance Health (Houston, TX)
- …+ Provides guidance for clinical operational aspects of a program. + Conduct peer -to- peer clinical appeal case reviews with attending physicians or other ... ordering providers to discuss review determinations. + Serves as a resource and consultant...or territory of the United States when conducting utilization review or an appeals consideration and cannot be located… more
- Houston Methodist (Houston, TX)
- …departments. + Responds to or clarifies internal requests for coding review by coders or department representatives. **QUALITY/SAFETY ESSENTIAL FUNCTIONS** + Ensures ... positive outcomes by monitoring and improving the department workflow, supporting peer -to- peer accountability, and identifying solutions via collaboration. Role… more
- Houston Methodist (Sugar Land, 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 (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
- CVS Health (Austin, TX)
- …and consistent responses to members and providers related to precertification, concurrent review , and appeal request. The medical director is a work-at-home position ... director will perform concurrent and prior authorization reviews with peer to peer coverage of denials. *...plan. Experience with managed care (Medicare and Medicaid) utilization review preferred. **Education** MD (Doctor of Medicine) or DO… 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 (Cypress, 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 (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
- Sam Houston State University (Huntsville, TX)
- …licensure, engage in ongoing training, and contribute to clinical supervision and peer consultation as needed. Adheres to all applicable ethical standards, legal ... II counselors, trainees, and interns. Leads or co-facilitates case conferences, peer consultation groups, or in-service trainings to enhance clinical practice and… more
- American Heart Association (Dallas, TX)
- …including active data collection, decision support tools, model practice sharing, peer to peer networking, collaborative facilitation, quality improvement ... a positive relationship in collaboration with region staff and leadership. Review program participation and opportunities for expansion into additional quality… more