Utilization Review Jobs in Houston
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Search Results - Utilization Review Jobs in Houston
Houston Methodist Hospital-Houston
rules and regulations; collaboration and relationships with payers; physician practice patterns; documentation and over- and under-utilization of resources. The Physician is a key member and leader of the hospital's utilization review/management...
Discovery Behavioral Health-Houston
on weekend or vacation call.
Collaborates with leadership in the interdisciplinary plan of care functions.
Participates in all required functions of utilization review, peer reviews, and appeals relative to the justification and authorization of treatment...
resume-library.com -
NCH Healthcare System-Houston
Actively collaborates with utilization review team to facilitate and meet organizational and department goals. · Recognizes situations that require referral to quality or risk management and makes a timely referral. EDUCATION, EXPERIENCE AND QUALIFICATIONS...
Memorial Hermann Health System-Houston
coordinate, and evaluate target drug programs, restricted drug programs, medication use-based performance assessment and improvement indicators, drug usage evaluation programs and cost containment programs.
• Develops and implements utilization reviews...
NCH Healthcare System-Houston
Actively collaborates with utilization review team to facilitate and meet organizational and department goals. · Recognizes situations that require referral to quality or risk management and makes a timely referral. EDUCATION, EXPERIENCE AND QUALIFICATIONS...
Memorial Hermann Health System-Houston
use-based performance assessment and improvement indicators, drug usage evaluation programs and cost containment programs.
• Develops and implements utilization reviews targeted for expensive, potentially harmful or improperly used drugs.
• Provides...
Houston
Process patient accounts and deploy established policies to resolve insurance issues with patient accounts.
12. Initiate pre‐cert for in‐house patients when required, obtaining pre‐certification reference number, approved length of stay, and utilization...
icims.com -
Houston
balance, continuous learning, and career development.
Summary
We are seeking a talented individual for an Associate Manager, Clinical Claim Review who is responsible for supervising the day:to:day prepay, post:pay, and utilization review activities...
tiptopjob.com -
Houston
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, short and long-term disability, Family and Medical...
icims.com -
Houston
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...
icims.com -
Houston
procedures, and performance standards and URAAC guidelines and state regulations.
Responsibilities:
MAJOR DUTIES AND RESPONSIBILITIES:
• Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity...
icims.com -
Houston
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...
icims.com -
Houston
patients when required, obtaining pre-certification reference number, approved length of stay, and utilization review company contact person and telephone number
• Notifies hospital Case Managers on all in-house patients regarding insurance plan changes/COB...
icims.com -
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