- Molina Healthcare (Austin, TX)
- …medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred ... requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial process. + Monitors appropriate care and services… more
- CenterWell (Grand Prairie, TX)
- …and welcoming environment for all. **Responsibilities:** The Nurse Practitioner (NP) or Physician Assistant (PA) works in our team-based care environment. We are a ... through daily huddles. . Helps Regional Medical Director (RMD), Physician and Center Administrator in setting a tone of...Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
- CenterWell (Grand Prairie, TX)
- …pay + bonus) could exceed $300K depending on experience and location.** The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a ... and spend more time with those they do. The Physician focuses on outpatient medicine, continuity of care, health...Clinical Leadership. Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
- CenterWell (San Antonio, TX)
- …part of our caring community and help us put health first** The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value-based ... Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues....required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- CenterWell (Beaumont, TX)
- …a part of our caring community and help us put health first** The Physician serves as a health-care professional and capable of handling a variety of health-related ... problems. The Physician work assignments involve moderately complex to complex issues...Leadership. . Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues.… more
- CenterWell (San Antonio, TX)
- …part of our caring community and help us put health first** The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a value-based ... Leadership. + Meets with RMD about quality of care, review of outcome data, policy, procedure and records issues....required to be screened for TB **Preferred Qualifications:** + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- Kelsey-Seybold Clinic (Stafford, TX)
- …corrective measures as indicated, including urgent care + Consult with primary care physician of services provided and collaborate with other physicians as needed + ... of clinical practice guidelines/standards in support of quality palliative care + Timely review , oversight, and documentation of patient care by team NP (s) or RN… more
- CenterWell (Houston, TX)
- …a part of our caring community and help us put health first** The Physician serves as a health-care professional and capable of handling a variety of health-related ... problems. The Physician work assignments involve moderately complex to complex issues...Meet with medical directors to discuss quality of care, review outcome data, and address policy, procedure, and records… more
- CommonSpirit Health (Houston, TX)
- …you must be licensed in the state of Texas. As the Utilization Management Physician Advisor (PA), the PA conducts clinical case reviews referred by case management ... message to all constituents. **Key Responsibilities** + Conducts medical record review in appropriate cases for medical necessity of hospital admission, continued… more
- Houston Methodist (Houston, TX)
- …to the Physician Advisor (or services) for appropriate second level review , peer-peer discussions, and payer denial- appeal needs. Consults with physician ... + Recent work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare , Medicaid, and Managed Care… more