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580 Ed Utilization Review Case Manager jobs in Houston,TX

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Senior Analyst, Risk & Quality Reporting (Remote)

Molina Healthcare

Houston, TX 77001

$63,435-$123,699/yr

Remote

Bachelor's Degree or equivalent combination of education and work experience
3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment
3-5 years of experience in working with data mapping, scrubbing, scrapping, and cleaning of data
3-5 years of experience in working with complex data to include quantifying, measuring, and analyzing financial/performance management and utilization metrics
1-3 years of experience with Microsoft Azure, AWS, or Hadoop
3-5 years of experience in Managed Care Organization executing similar techno functional role that involves writing complex SQL Queries, Functions, Procedures and Data design
3-5 years of experience working with Microsoft T-SQL, Databricks SQL and PowerBI

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Economics Content Reviewer

Sepal

Houston, TX 77246

$60-$95/hr

Remote

Demonstrated experience with: Teaching, mentoring, training, or assessing professional work
Advanced degree, professional certification, or equivalent experience in the relevant occupation or field
Strong understanding of professional boundaries, risk, and compliance considerations
Demonstrated experience with: Evaluation, review, auditing, or supervisory responsibilities
Excellent written communication skills suitable for formal feedback
5+ years of professional experience practicing in that domain

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Program Manager

Texas Childrens Hospital

Houston, TX 77086

Onsite

Bachelor's Degree required
3 years Program manager or related role with oversight of multiple programs preferred
RN - Lic-Registered Nurses Texas Board of Nursing or Nurse Licensure Compact required
3 years' Experience in a health plan and utilization management required

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Community Health Worker

Oak Street Health

Houston, TX 77002

Requires TravelFlexible ScheduleBilingual PreferredEducation AssistanceHealth InsurancePaid Time OffRetirement Benefit

Access to reliable transportation and ability to travel throughout the community to various locations
Minimum of 1 year of experience in healthcare, community-based, case management, or social service environment
Strong oral and written communication skills
Ability to manage multiple priorities while maintaining a positive attitude
Dedication to serving the community and building meaningful relationships
Proficient computer skills (i.e. Windows, GSuite, Microsoft, etc.)
US work authorization

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In Home Sales Representative

Erie Home

Pasadena, TX 77504

$125,000-$250,000/yr

~ 33 min OnsiteHealth InsuranceRetirement Benefit

Valid driver's license, reliable transportation with auto insurance, and the ability to travel to and from in-home appointments.
No sales or construction experience needed
Midday, evening, & weekend availability

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Medical Records Director Non Nurse/HIM

Garden Terrace Alzheimer's Center of Excellence (Houston)

Houston, TX 77054

Onsite

Maintains confidentiality of all proprietary and/or confidential information
Make independent decisions when circumstances warrant such action
Promotes a culture of integrity, maintains an “open door” policy, and does not participate in or allow retaliation against those who report good faith concerns
Actively implements the compliance program and Code of Conduct and ensures 100% participation by department staff
Read, write, speak, and understand the English language
Training in post-acute care health information management
Demonstrate knowledge of State and Federal legal requirements relating to documentation, confidentiality, and legal issues pertaining to health information
Sit, stand, bend, lift, push, pull, stoop, walk, reach, and move intermittently during working hours
Must be able to lift 35 lbs floor to waist, lift 35 lbs waist to shoulder, lift and carry 35 lbs, and push/pull 35 lbs
Functional knowledge in field of practice
Knowledgeable of medical records practices and procedures as well as the laws, regulations, and guidelines governing medical records functions in the post-acute care facility
Understand and follow company policies including harassment and compliance procedures
Bachelor's degree OR an equivalent combination of education and experience
Credentialed as a Registered Health Information Administrator (RHIA) OR as a Registered Health Information Technician (RHIT) OR have a degree in a health related field with extensive training and demonstrated competence in the HIM field
Perform proficiently in all competency areas including but not limited to: medical coding, auditing, clinical records, privacy official responsibilities, supervisory responsibilities, patient rights, and safety and sanitation
Demonstrate efficient usage of complex computer software systems
Displays integrity and professionalism by adhering to Life Care's Code of Conduct and completes mandatory Code of Conduct and other appropriate compliance training
Implement and interpret the programs, goals, objectives, policies, and procedures of the medical records department

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Service Manager (57210)

Houston, TX 77063

Onsite

300-500 units in one community.
Ability to work with both hands for frequent grasping and manipulation.
Required Certifications: EPA Core, Type I-Appliances, Type II-HAVC, Certified Pool Operator
Operation of a motor vehicle onsite, if applicable.
Regularly performs manual, task-oriented work independently and prioritize tasks.
Minimum of five or more years of progressive maintenance and safety experience.
Required to provide own (industry specific) hand tools.
Lifting up to 50 pounds.
Full range of motion with upper and lower body. Continuous movement, including, but not limited to, standing, walking, bending, stooping, crawling, and climbing stairs.
Exposure to all weather conditions.
Push or pull items and reach overhead.
Assigning tasks to large team.
Advanced computer skills and industry specific technology to coordinate and help respond to resident/management requests for the property.

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Program Supervisor

Sevita

Baytown, TX 77522

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Vice President, Client Operations - CLO/Structured Debt

BNY

Houston, TX 77002

Health Insurance

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Assembler - Hiring Now

Alfa Laval

Houston, TX 77038

$23-$25/hr

OnsiteHealth InsurancePaid Time OffRetirement Benefit

Experience with pneumatic and hand tools, basic Engineering drawings, and basic electrical and hydraulic terminology.
You have a high school diploma or equivalent (G.E.D.) with relevant experience, and:
Minimum 1 year of professional experience in the assembly of mechanical equipment or a similar field.

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