Top 112 Utilization review Jobs in Houston, Tx

Director of Advanced Clinical Documentation Systems
Advanced Diagnostics Hospitals & Clinics —Houston, TX
- $110,000 - $120,000 a year
- Full-time
- Background check
- Nursing
- RN License
- Free parking
- Health savings account
Quick Apply
3d
Utilization Management Representative - Remote
Optum —Pearland, TX
- $16 - $29 an hour
- Full-time
- Hybrid work
- Computer literacy
- Medical office experience
- Pass drug screening
Quick Apply
7d
Utilization Management Specialist I
SUN Behavioral Houston —Houston, TX
- PRN
- CPR Certification
- Writing skills
- BLS Certification
- Employee assistance program
- 401(k) matching
UTILIZATION REVIEW NURSE - RN
Nexus Health Systems Ltd —Houston, TX
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply
Nurse, Concurrent Review
HealthHelp - A WNS Company —Houston, TX
- $75,000 a year
- Weekends as needed
- Remote
- Nursing
- Microsoft Excel
- RN License
- AD&D insurance
- Paid holidays
Quick Apply
9d
RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic
Optum —Pearland, TX
- $60,200 - $107,400 a year
- Full-time
- Hybrid work
- Nursing
- RN License
- Computer literacy
Quick Apply
3d
Office Coordinator
Westpark Springs —Houston, TX
- Full-time
- CPR Certification
- Hospital
- BLS Certification
- Disability insurance
- Health insurance
Quick Apply
Nurse - Clinical Review
HealthHelp - A WNS Company —Houston, TX
- $65,000 - $75,000 a year
- Email
- Remote
- Nursing
- Microsoft Excel
- LVN
- Health insurance
- Dental insurance
Quick Apply
Behavioral Health Care Advocate - UM - Remote
Optum —Houston, TX
- $60,200 - $107,400 a year
- Full-time
- Microsoft Outlook
- Pass drug screening
- Mid-level
Quick Apply
14d
Insurance Verification Representative-PT
West Oaks Hospital —Houston, TX
- Part-time
- Acute care
- Psychiatry
- Adults
- Paid time off
- 401(k) matching
Utilization Specialist - Hybrid
Eduvention Mentoring & Consulting —Houston, TX
- Monday to Friday
- HIPAA
- Mid-level
- Master's degree
- Paid time off
2d
Senior Consultant - Clinical Documentation Specialist
Deloitte —Houston, TX
- $110,700 - $218,300 a year
- Full-time
- Microsoft Word
- Nursing
- RN License
Quality Outcomes Specialist
Houston Methodist Willowbrook Hospital —Houston, TX
- Full-time
- Nursing
- RN License
- Customer service
RN Case Manager Acute Care
River Oaks Hospital and Clinics —Houston, TX
- $70,000 - $80,000 a year
- Full-time
- Background check
- Spanish
- Nursing
- Disability insurance
- Health insurance
Quick Apply
Floater Pharmacist
Avita Care Solutions —Bellaire, TX
- Full-time
- Spanish
- Management
- Customer service
- Travel reimbursement
- Paid jury duty
8d
Regional MDS
Tikva Healthcare —Texas
- $80,000 - $100,000 a year
- Full-time
- Anatomy knowledge
- RN License
- HIPAA
- Travel reimbursement
- Health insurance
Quick Apply
9d
Case Manager-Registered Nurse (RN)
Houston Methodist Hospital —Houston, TX
- Part-time
- Acute care
- Nursing
- Microsoft Excel
6d
Case Manager-Registered Nurse (RN)-PRN
Houston Methodist Hospital —Houston, TX
- PRN
- Acute care
- Nursing
- Microsoft Excel
Manager, Trauma Case Management
Career Land Center, LLC —Houston, TX
- Full-time
- Acute care
- RN License
- Hospital
- Relocation assistance
- Health insurance
Quick Apply
Corporate Director of Care Management
Stark Lane, Inc. —Houston, TX
- Nursing
- 7 years
- RN License
- Health insurance
- Dental insurance
Quick Apply

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utilization review jobs near houston, tx

Director of Advanced Clinical Documentation Systems

Advanced Diagnostics Hospitals & Clinics
Houston, TX

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Job Details

Full-time
$110,000 - $120,000 a year
3 days ago

Benefits

Free parking
Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
Life insurance

Qualifications

Nursing
RN License
Employee relationship building
Bachelor's degree
Clinical documentation
Bachelor's degree in nursing
Master of Business Administration
Nursing

Full Job Description

OVERVIEW

Advanced Diagnostics Healthcare System is an independent, physician-led and patient-centered organization of hospitals, clinics and diagnostic centers in Texas. We are entirely focused on bringing you advanced, comprehensive care and superior patient experience. As we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a collaborative manner.

JOB SUMMARY

The Director of Advanced Clinical Documentation is the key facility resource responsible for delivering the successful implementation of clinical documentation systems. They are responsible for coordinating the completion of project assessments and parameter settings and assisting with the development of education/training materials. This individual participates in the company-wide community for computerized physician order entry, physician and nurse clinical documentation, and works with their corporate peers to ensure advanced clinical applications are well supported throughout the facility and integrated with other services including accounting and quality.

They are responsible for coordinating the completion of project assessments and parameter settings and assisting with the development of education/training materials. This individual participates in the company-wide community for CPOE and works with their division peers to ensure advanced clinical applications are well supported throughout the facility for implementation through maintenance.

DUTIES AND RESPONSIBILITIES

· Implementation and support of system-wide standardization, utilization, integration, and optimization activities related to the electronic medical record for hospital-based services and advanced clinical applications and tools.

· Development, execution, and support of education plan, tools and resources focused on the optimizing clinical initiatives.

· Facilitation and project leadership of the transition to Strateq and GoRev for new facilities and integration with advanced clinical system functions implementation as well as support for Athena clinicals facilities.

· Resolution of complex issues and requests escalated from the division Service Desk or system or facility service resources.

· Evidence Based Order set review, approval, and build within the facility.

· Ongoing monitoring of various advanced clinicals usage trend reports. Identify gaps/areas of opportunity and develop action plan to address areas of concern.

· Provides leadership and representation on executive committees (Med Exec, Administration, etc), serves as communications specialist for physician stakeholders.

· Identify gaps and opportunities in departmental process mapping of current state and the future state workflows.

· Provide system and operations expertise for implementation of process & system changes.

· Provide Go-Live support (elbow support), and order workflow support.

· Participate in systems training for project team, serve as Super User for Clinicians and training and develop of Super Users for various sites.

· Provides specialized support for physicians during Go-Live with leadership of go live support team.

· Works with Clinical leaders and nursing supervisors to implement education specialists throughout system and to design and develop base education/training materials in clinical documentation to support staff training and continued education.

· Actively supports and promotes systems standardization, utilization, and best practices in all areas of clinical documentation.

· Adheres to Code of Conduct and Mission & Value Statement.

· Participates in special projects as needed and performs other duties as assigned.

REQUIREMENTS

· Current Registered Nurse License in the State of Texas

· Minimum of 5 years progressive experience in an acute care setting in a variety area with strong clinical informatics, project management, relationship building, and regulatory compliance experience preferred.

EDUCATION

· Bachelor's degree in nursing required. Master's degree MHA, MSN, MBA preferred.

CERTIFICATION, LICENSURE

· Current Registered Nurse License in the State of Texas

KNOWLEDGE SKILS AND ABILITIES

· Mature understanding of Athena clinicals and ability to translate knowledge to alternative EMR systems as required.

· Experience with physician and clinical training.

· Understands pertinent regulatory guidelines such as Joint Commission standards, Medicare conditions of participation, HIPAA and ACR.

· Demonstrated ability to establish and build strong relationships across a broad range of personality types.

Pay: $110,000.00 - $120,000.00 per year

Benefits:

401(k)
Dental insurance
Flexible spending account
Free parking
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance

Work Location: In person

Quick Apply

Refine Your Search

utilization review jobs in houston, tx

Director of Advanced Clinical Documentation Systems

Utilization Management Representative - Remote

Utilization Management Specialist I

UTILIZATION REVIEW NURSE - RN

Nurse, Concurrent Review

RN Concurrent Review - UM - Remote - Kelsey Seybold Clinic

Office Coordinator

Nurse - Clinical Review

Behavioral Health Care Advocate - UM - Remote

Insurance Verification Representative-PT

Utilization Specialist - Hybrid

Senior Consultant - Clinical Documentation Specialist

Quality Outcomes Specialist

RN Case Manager Acute Care

Floater Pharmacist

Regional MDS

Case Manager-Registered Nurse (RN)

Case Manager-Registered Nurse (RN)-PRN

Manager, Trauma Case Management

Corporate Director of Care Management

I want to receive the latest job alert for utilization review in houston, tx

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