- HCA Healthcare (Austin, TX)
- …Program Manager using facility approved audit tools. As the NICU Clinical Nurse Reviewer , . You will review patient's medical record and documents' compliance ... apart from any other healthcare provider. We are seeking a(an) Clinical Nurse Reviewer Neonatal ICU to join our healthcare family. **Benefits** St. David's North… more
- Elevance Health (Houston, TX)
- **Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... **with rotating weekends.** **New Grads are encouraged to apply!** The **Nurse Reviewer I** will be responsible for conducting preauthorization, out of network and… more
- Insight Global (Plano, TX)
- Job Description Insight Global is looking for an Infrastructure Quality Assurance Reviewer to join a food & beverage client remotely in Mexico. Responsible for ... we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/. Skills and… more
- TEKsystems (Houston, TX)
- …skills to support compliance and operational excellence. Key Responsibilities + Review and analyze borrower organizational charts to confirm ownership structures, ... or red flags in organizational hierarchies and escalate for further review . + Review legal formation documents for LLCs, partnerships, corporations, and trusts… more
- Centene Corporation (Austin, TX)
- …and member complaints related to psychological testing or other services requiring review by a PhD/PsyD + Facilitate outpatient rounds offering clinical input and ... oversight related to outpatient services + Performs other duties as assigned. + Complies with all policies and standards. **Education/Experience:** **PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required** **:** 2+ years Behavioral… more
- Evolent (Austin, TX)
- …with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United States. Acts ... with honor and integrity, serving as a role model for the company. Performs other duties as assigned. **QUALIFICATION REQUIREMENTS** : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements… more
- PNC (Houston, TX)
- …or issues.Participates in continuous monitoring for assigned portfolios. + Oversees file review activities of reviewers as Reviewer in Charge for assigned ... success. We are looking to hire a Credit Risk Review Advisor Senior in Credit Risk Review ...credit exposures. You may have responsibility of being a Reviewer in Charge. The Reviewer in Charge… more
- CVS Health (Austin, TX)
- …extraction and analysis, dedicated to a specific self-funded plan sponsor. The lead reviewer is accountable for the validation of existing fraud waste and abuse ... analyze and document analytic leads or referrals to send for investigative review . + Review company clinical and payment policies to determine the impact of the… more
- Terracon (Pharr, TX)
- …of plans and specifications, observation and inspection, and the writing, preparation, and review of related reports for the services provided. Review drawings ... and recommend changes. Research and resolve design and construction problems. Assign, review , and evaluate laboratory or field data for inclusion in reports. Apply… more
- HCA Healthcare (Houston, TX)
- …important to you, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. Our team will promptly review your application. Highly qualified ... positions. Join our Team as a(an) Registered Nurse Clinical Reviewer and access programs to assist with every stage...job skills. Apply today for our Registered Nurse Clinical Reviewer opening and continue to learn! **Job Summary and… more