- MTC (Raymondville, TX)
- **Pay: $265,000 annual salary** **Work schedule: Full -time, Monday - Friday, days** **Benefit package includes:** + **Medical, Vision, Dental, and Prescription Drug ... clinical impressions. 2. Inspect, complete and analyze medical records, assign review and update medical classifications; complete admission notes, progress notes,… more
- HCA Healthcare (Live Oak, TX)
- …a data-driven environment of quality and cost improvement, and develops systems to review utilization of resources and objectively measure outcomes of care in ... support for appeals and denials process, discharge planning, case management, and utilization review /management + You will consult with facility-level staff… more
- Centene Corporation (Austin, TX)
- …management, cost containment, and medical quality improvement activities. + Performs medical review activities pertaining to utilization review , quality ... physician education with respect to clinical issues and policies. + Identifies utilization review studies and evaluates adverse trends in utilization of… more
- Houston Methodist (The Woodlands, TX)
- …patient satisfaction and safety measures. **FINANCE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use, ... benefits for patients and reimbursement for the hospital. + Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource … more
- Houston Methodist (The Woodlands, TX)
- …safety. The CQO position collaborates with the System CQO and other system physician leadership in quality and patient safety to support the development of the ... 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)
- …improvements, patient satisfaction). **PEOPLE ESSENTIAL FUNCTIONS** + Collaborates with the physician and all members of the interprofessional health care team to ... for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use,… more
- CVS Health (Austin, TX)
- …Qualifications** * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. **Education** * Active ... efficiency involving clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including...range represents the base hourly rate or base annual full -time salary for all positions in the job grade… more
- HCA Healthcare (Houston, TX)
- …and Medical Staff with referral of all cases in question to the Utilization Management Physician Advisor. + Communicates with third party payers regarding ... + Employee Health Assistance Fund that offers free employee-only coverage to full -time and part-time colleagues based on income. Learn more about Employee Benefits… more
- Houston Methodist (Houston, TX)
- …while providing excellent customer/patient service. + Plays a leadership role in utilization review committee which includes identification of opportunities for ... most clinically appropriate care to patients while promoting the most cost-effective utilization of the hospital's resources. The Director Case Mgmt Social Svcs… more
- Abbott (Plano, TX)
- …required clinical information for authorizations. + Work with respective carrier's utilization review department to obtain appropriate authorizations. + Assist ... and family, be your true self and live a full life. You'll also have access to: + Career...Worker's Compensation and Medicare guidelines pertaining toProspective and Retrospective Utilization Review . Some experience in medical deviceor… more