Top Healthcare Services Jobs in Austin, TX

Provide onsite EAP services including assessment, referral, crisis intervention, manager consultation, limited after-care monitoring, training, and documentation while maintaining HIPAA and licensing standards.

Provide physician oversight for utilization management and pre-service coverage determinations, conducting clinical reviews, documenting findings, engaging in peer-to-peer discussions, collaborating with providers and internal teams, participating in clinical rounds, and supporting quality, cost-effectiveness, and policy interpretation to ensure appropriate member care.

Provide physician oversight for medical claims and coverage determinations in plastic surgery, collaborate with providers and internal teams, document reviews, and participate in utilization management and quality improvement.

Provide utilization review determinations and clinical guidance for oncology populations, support case and disease management, apply NCCN evidence-based guidelines, engage treating providers, educate nursing teams, analyze clinical and utilization data, and collaborate on enterprise research and quality initiatives to improve oncology care.

Provide physician support for enterprise clinical services by conducting coverage and utilization reviews for sleep medicine, documenting findings, engaging in peer-to-peer provider discussions, collaborating with internal teams, participating in clinical rounds, and covering occasional call/holiday rotations to ensure cost-effective, evidence-based care for members.

Provide physician oversight for clinical coverage and post-service medical necessity determinations for urology cases, document findings, engage in peer-to-peer discussions, collaborate with providers and internal teams, and support quality, cost-effectiveness, and policy interpretation in utilization management.

Provide physician clinical support for medical claims and coverage determinations, perform clinical reviews per benefit plans and policies, document findings, engage in peer-to-peer provider discussions, participate in clinical rounds, and collaborate with multidisciplinary and internal teams to ensure appropriate, cost-effective care for members.

Provide physician clinical review for medical claims and coverage determinations in hematology/oncology, document findings, engage in peer-to-peer discussions, collaborate with providers and internal teams, participate in quality improvement, and ensure cost-effective, evidence-based care consistent with benefit plans and policies.

Provide physician oversight for clinical claims and coverage determinations related to sleep and pulmonology. Conduct benefit and medical necessity reviews, document findings, engage in peer-to-peer discussions with providers, participate in clinical rounds, and collaborate with internal teams to ensure cost-effective, evidence-based member care.

Provide physician-led clinical review and coverage determinations for post-service claims, collaborating with providers and internal teams to ensure medically appropriate, cost-effective care. Document findings, engage in peer-to-peer discussions, interpret benefit language and policies, and contribute to quality improvement and provider education.