Utilization Review Jobs in Houston
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Search Results - Utilization Review Jobs in Houston
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
Ascendo ResourcesHouston
Specialties (minimum three years).
• At least three years of experience as an attending physician.
• Prior experience within the Medicare, health insurance, or utilization review environment.
• Strong understanding of clinical evidence evaluation and medical...
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
Houstonicims.com
and URAAC guidelines and state regulations.
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES:
• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work...
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
Dane Street, LLCHoustonworkable.com
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise
• Expanded credentials as an expert in Independent Medical Exams and physician advisor services
• No-show fees and late...
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
Houstonicims.com
licensed in the Oklahoma, Missouri, Texas, and Kansas.
2. A minimum of two years’ experience in hospice Compliance and previous clinical experience in home health, long-term care, oncology, or geriatric nursing.
3. Utilization Review, Compliance, QI...
University HealthHoustontiptopjob.com
and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), National Committee for Quality Assurance (NCQA) that promotes Healthcare Effectiveness Data and Information Set (HEDIS) metrics, Utilization Review Accreditation Commission (URAC...
Physician / Other / Texas / Permanent / Associate Medical Director - Maternal Fetal - 100% Remote...
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
Houstontiptopjob.com
Management, Drug Utilization Review
typedisc:
• Systems Integration and Interoperability: SI Platform, FHIR, EDI Interoperability
typedisc:
• Analytics: Enterprise Data Warehouse, Program Insights and Dashboards (NASPO, HEDIS), Benchmarking
typedisc:
• Cost...
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
Houstontiptopjob.com
with hospital leadership and clinical committees to design and implement processes that enhance patient care quality, efficiency, and resource stewardship.
• Serve as Chair of the Utilization Review Committee, providing administrative and clinical oversight...
eviCore healthcareHouston
Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.
Reviews appeals for denied services related...
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