- CenterWell (Fort Worth, TX)
- …performance in patient experience, quality of care, clinical outcomes, and avoidable utilization *Periodically review clinician charts to identify ... and operational budgeting, and monitor clinical & financial performance and metrics. * Review clinician schedules and incentive plans to align with patient… more
- CenterWell (Arlington, TX)
- …clinical performance in patient experience, quality of care, clinical outcomes, and avoidable utilization + Periodically review clinician charts to identify ... of health (SDOH) efforts, improving clinical outcomes and avoidable utilization + Monitor and manage daily patient care and...and monitor clinical & financial performance and metrics. + Review clinician schedules and incentive plans to… more
- Molina Healthcare (TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... JOB DESCRIPTION Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically… more
- Molina Healthcare (TX)
- **JOB DESCRIPTION** Opportunity for experienced Utilization Review RN (preferred) or LPN with a compact license who resides in New Mexico or Texas. This team ... field, such as social work or clinical counselor (for Behavioral Health Care Review Clinicians only). **Required Experience** 1-3 years of hospital or medical clinic… more
- Molina Healthcare (Houston, TX)
- …Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of Interqual ... / MCG guidelines. **Preferred License, Certification, Association** Active, unrestricted Utilization Management Certification (CPHM). MULTI STATE / COMPACT LICENSURE… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Provides support for clinical member services review assessment processes. Responsible for verifying that services are medically ... multidisciplinary teams to promote the Molina care model. * Adheres to utilization management (UM) policies and procedures. **Required Qualifications** * At least 2… more
- HCA Healthcare (Dallas, TX)
- …and other parties as appropriate regarding behavioral services** + **Performs utilization review as assigned** + **Participates in developing department ... hours volunteering in our communities. As a(an) Licensed Intake Clinician with Medical City Green Oaks Hospital you can...organization. We are looking for an enthusiastic Licensed Intake Clinician to help us reach our goals. Unlock your… more
- Sedgwick (Austin, TX)
- …(10) of related experience required to include one (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & ... criteria; to provide leadership within the dedicated team of clinician and claim professionals in support of the dedicated...+ Knowledge of ADAA and FMLA + Knowledge of utilization review procedures + Knowledge of clinical… more
- Texas Tech University Health Sciences Center - El Paso (El Paso, TX)
- …Administrator and Department Chair, assist with physician productivity and facility utilization . + Regularly review established benchmarks (including but not ... limited to cFTEs) to monitor clinician productivity and make recommendations to the Department Administrator for cFTE or benchmark adjustments. + Participate in … more
- BrightSpring Health Services (San Antonio, TX)
- …+ In-service behavior clinician (s) on all changes made to regulations. + Review all billing for BCBAs, BCaBA's, RBTs and Behavior Technicians on a minimum the ... professional teams. Provide staff/family training on implemented programs. + Review all Functional Behavior Assessments/Behavior Support Plans prior to… more
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