- TEKsystems (Austin, TX)
- …audit chemotherapy regimens for medical necessity and pathway adherence. + Communicate insurance requirements to clinical staff and resolve documentation or ... preferred. Minimum three (1-3) years of radiation, chemo, OR surgery medical insurance verification and authorization required. Experience Level Expert Level Pay and… more
- HCA Healthcare (Pasadena, TX)
- …want to join an organization that invests in you as a Coding Quality Audit Reviewer ? At Parallon, you come first. HCA Healthcare has committed up to $300 million in ... members over the course of three years. **This position is fully remote /work from home!** **Schedule: Monday-Friday Day Shift** **Must have DRG Validation experience… more
- Centene Corporation (Austin, TX)
- …on workplace flexibility. POSITION IS REMOTE **Position Purpose:** Perform clinical /coding medical claim review to ensure compliance with coding practices ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene...through a comprehensive review and analysis of medical claims, medical records, claims… more
- Cognizant (Austin, TX)
- …and retro-authorization as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral, preauthorization, ... **Schedule:** Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse...determinations to the Health Plan/Medical Director based on the review of clinical documentation in accordance with… more
- Prime Therapeutics (Austin, TX)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Clinical Account Director - Remote **Job Description** The Clinical Account ... beneficial or of interest to the plan + Provide clinical guidance and support for client's Health Insurance...$124,000.00 - $211,000.00 based on experience and skills. To review our Benefits, Incentives and Additional Compensation, visit our… more
- Teleflex (Dallas, TX)
- Clinical Affairs Manager, Interventional Access ( REMOTE ) **Date:** Oct 11, 2025 **Location:** dallas, TX, US **Company:** Teleflex **Expected Travel** : Up to ... Summary** **TRAVEL REQUIRED: 50% (Domestic and International; overnight required)** The Clinical Affairs Manager will provide clinical expertise, insight, and… more
- Evolent (Austin, TX)
- …when available, within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure consistency in the ... clinical professionals. + A role that values innovation, continuous improvement, and clinical excellence. + **This position is 100% Remote and can be… more
- Providence (TX)
- …timely and accurate preparation and maintenance of budget templates for sponsored clinical trials, including the comparative review against budgets offered by ... **Description** ** Clinical Budgeting Analyst** **_Remote_** **Candidates residing in Alaska,...employer matching, health care benefits (medical, dental, vision), life insurance , disability insurance , time off benefits (paid… more
- TEKsystems (Dallas, TX)
- Join Our Team as a Clinical Quality Assurance Coordinator! Are you passionate about healthcare quality and compliance? Do you thrive in a detail-oriented environment ... we want to hear from you! We're seeking a Clinical Quality Assurance Coordinator to join our dynamic team....In this pivotal role, you'll ensure that our peer review reports meet the highest standards of quality, accuracy,… more
- Centene Corporation (Austin, TX)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
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