Trusted Health Zip Code Jobs in Usa
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Conducts comprehensive clinical reviews of adverse determinations related to medical necessity.
Initiates outreach to providers to obtain clarification or additional documentation in alignment with established clinical criteria and organizational policies, to support Medical Director decision making.
Provides support for claim appeals in relation to medical necessity.
Ensures the timely and accurate resolution of appeal cases and supports organizational adherence to all state, federal, and accreditation standards.
Facilitates member second level appeal process.
Graduate from an accredited school of professional nursing is required.
BSN preferred.
Minimum 2 years acute care experience or managed care experience is required.
Basic knowledge of Medicaid, Medicare preferred.
Knowledge of InterQual screening criteria, ICD-10, CPT coding preferred.
Current Registered Nurse (RN) license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required.
Active Certification in Case Management (CCM) is preferred.
Busy office of 6 physicians looking to replace retiring provider. Part of academic pediatric department of 44 full time physicians with full complement of pediatric subspecialists
Call schedule of 1:18 with no ER or Hospital call
4-day work week
Approximately 30-35 patients per day
$30 Million Pediatric Hospital with Level III NICU
Affiliated with a large academic medical center with a dedicated pediatric hospital
Serves a population of over 1 million children and adults
First year salary guarantee with opportunity to make 90th percentile MGMA academic total compensation in 2nd year with generous benefits package including moving expense, signing bonus and retirement plan with 6% match
Low-cost health insurance premiums
Medical School offers training in 10 residency and 14 fellowship programs with over 250 residents / fellows on campus working alongside 400 providers in 75 areas of primary and specialty care
Residency programs in both Pediatrics and Internal Medicine/ Pediatrics and fellowship programs in Pediatric Hospital Medicine and Neonatal-Perinatal Medicine
Employer paid occurrence malpractice insurance
H1b candidates and 2023 J1 candidates accepted
One of America s 100 Best Hospitals - Healthgrades
An outdoor enthusiasts haven
Comforts of a small town
Lower cost of living
Locally owned restaurants and specialty shops
Cultural diversity
Outdoor activities with beautiful mountains and scenery
Distinct four-season
The regions best skiing at your doorstep
Year-round family fun
NCAA Division One Intercollegiate Sports Teams
Rob Rector
Direct:
F:
Cell / Text:
MENTION CODE 240804 - PD
Minimum Requirements:
MD or DO Medical Degree
Eligible to be state licensed in the United States
United States Residency and / or Fellowship training
Position Title Behavioral Health Assessor Marillac Campus Position Summary / Career Interest: The Behavioral Health Assessor has the responsibility to provide a full range of services for patients and their families, including clinical assessments, treatment planning, crisis management as well has insurance authorization.
The role of this position incudes collaboration with nursing staff as well as the medical team to determine the appropriate level of care through a clinical assessment.
Responsibilities and Essential Job Functions Assesses patient for risk factors that would lead to hospitalization.
Diagnoses patient by collecting and evaluating information about the patient's situation.
Consults with the multidisciplinary team and patient/family during the assessment.
Reviews clinical information with the medical team to determine if admission is necessary at the time of assessment Develops patient's treatment plan by establishing treatment goals and objectives with the patent/family and consults with the multidisciplinary team.
Reviews disposition with patient, family and provide support when needed.
Communicates safety plan and provides resources to patients and families who do not meet medical criteria for hospitalization.
Assures quality service for clients by enforcing rules, regulations, and legal requirements with clients, documenting events of the therapeutic process in a confidential manner.
Maintains agency credibility by establishing working relationships with sponsoring, advisory, and related service agencies.
Promotes the agency by ensuring an understanding of program services available for clients; publicizes activities and accomplishments.
Provides a clinical experience for interns by negotiating learning objectives; supervises practice and caseload management, teaching theory and its application; evaluates skills and personal and professional growth, ensuring identification with the profession.
Continues education, participates in workshops and reviews professional publications and establishing personal networks.
Accepts responsibility and accountability for achievement of optimal outcomes within their scope of practice.
Follows policies, procedures and standards; adheres to a professional code of ethics.
Assumes responsibility for the risk and safety issues associated with the position.
Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities.
Skills and duties may vary dependent upon your department or unit.
Other duties may be assigned as required.
Required Education and Experience High School Graduate Bachelors Degree Master's Degree from accredited University in Social Work, Counseling, Psychology or Marriage and Family Therapy.
1 or more years of related experience Required Licensure and Certification Master's level Licensure with the Behavioral Sciences Regulatory Board as one of the following: Licensed Professional Counselor (KS) Licensed Master Social Worker (KS) Licensed Marriage and Family Therapist (KS) Knowledge Requirements Computer literate and high knowledge of various computer software programs.
Ability to engage clients and families.
Time Type: Job Requisition ID: R-45301 Important information for you to know as you apply: The health system is an equal employment opportunity employer.
Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status.
See also Diversity, Equity & Inclusion .
The health system provides reasonable accommodations to qualified individuals with disabilities.
If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link .
Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.
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University Health is seeking a compassionate and skilled Physician to provide high-quality medical care to individuals housed in the Bexar County Adult Detention Center. This unique role offers the opportunity to serve a population with complex health needs in a secure environment while working within one of Texas' leading academic health systems.
You'll be part of a multidisciplinary team committed to improving the health and well-being of patients while ensuring safe, ethical, and professional medical care.
Key Responsibilities
- Provide comprehensive health care services within your specialty to individuals housed in the Bexar County Jail.
- Diagnose, treat, and manage acute and chronic medical conditions for incarcerated patients.
- Collaborate with nursing staff, mid-level providers, and correctional officers to deliver safe and effective patient care.
- Accurately document patient encounters and submit billing/coding information in compliance with policies.
- Participate in quality improvement activities, chart reviews, and peer audits.
- Support teaching and training opportunities with UT Health San Antonio medical students and residents.
- Participate in a rotational on-call schedule.
- Ensure care delivery aligns with University Health's mission, values, and established correctional health standards.
Qualifications
- MD or DO from an accredited medical school.
- Completion of an ACGME-accredited residency program.
- Board certification or board eligibility in your specialty.
- Texas medical license (or ability to obtain prior to start).
- AHA BLS certification required; ACLS (or specialty equivalent) required within 90 days for acute care.
- Active DEA and DPS registrations.
- Correctional health care experience is a plus, but not required.
- Spanish/English bilingual preferred.
What We're Looking For
- A physician with a strong sense of social responsibility and a desire to serve underserved and justice-involved populations.
- Ability to adapt medical care to patients with diverse cultural, psychosocial, and developmental needs.
- Skilled communicator who can work effectively with patients, staff, and correctional personnel.
- A commitment to quality, safety, and compassionate care even in challenging environments.
Why Join University Health?
At University Health, you'll find more than a job—you'll find a calling. Working in detention health care offers:
- The chance to positively impact vulnerable populations.
- A supportive, team-based work environment.
- Opportunities for teaching and mentorship through our academic partnerships.
- Competitive compensation and a comprehensive benefits package.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
Identifies Community First Health Plan members with specific health care needs and provides case management interventions. Analyzes, approves health care services and monitors outpatient care planning for Community First Health Plans members based on established criteria, plan policies and procedures. Formulates and communicates case management plans that efficiently utilize health care services to move the member along the continuum of care towards optimum outcomes in the safest, most cost effective manner.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required, BSN preferred. Master’s degree is preferred. Minimum three years’ acute care experience or managed care experience is required. Minimum one-year of concurrent review experience is required. Candidate must have utilization management and/or quality assurance experience. Basic knowledge of Medicaid, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current Registered Nurse license to practice professional nursing issued by the Board of Nurse Examiners for the State of Texas is required. Active Certification in Case Management (CCM) designation is preferred.
Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include but are not limited to overseeing the allocation of resources, cost and quality of health care for members; coordinating care between the primary care physician, community resources, family and member; coordinating care across the health care continuum while monitoring and managing benefit utilization; and, collaborating with multi-disciplinary health care team members in identifying the educational and discharge needs of members.
EDUCATION/EXPERIENCE
Registered Nurse (RN) is required. Bachelor of Science in Nursing (BSN) or Master’s degree is preferred. Minimum three (3) years nursing, acute care, quality management or managed care experience is required. Basic knowledge of Medicaid, Medicare, community resources and alternate funding programs is desired. Knowledge of InterQual screening criteria as well as DRG, ICD and CPT coding is preferred.
LICENSURE/CERTIFICATION
Current licensure as a Registered Nurse with the Texas State Board of Nurse Examiners is required. Current certification from an appropriate professional agency, such as Case Management Society, is preferred.
University Health is seeking a compassionate and skilled Physician to provide high-quality medical care to individuals housed in the Bexar County Adult Detention Center. This unique role offers the opportunity to serve a population with complex health needs in a secure environment while working within one of Texas' leading academic health systems.
You'll be part of a multidisciplinary team committed to improving the health and well-being of patients while ensuring safe, ethical, and professional medical care.
Key Responsibilities
- Provide comprehensive health care services within your specialty to individuals housed in the Bexar County Jail.
- Diagnose, treat, and manage acute and chronic medical conditions for incarcerated patients.
- Collaborate with nursing staff, mid-level providers, and correctional officers to deliver safe and effective patient care.
- Accurately document patient encounters and submit billing/coding information in compliance with policies.
- Participate in quality improvement activities, chart reviews, and peer audits.
- Support teaching and training opportunities with UT Health San Antonio medical students and residents.
- Participate in a rotational on-call schedule.
- Ensure care delivery aligns with University Health's mission, values, and established correctional health standards.
Qualifications
- MD or DO from an accredited medical school.
- Completion of an ACGME-accredited residency program.
- Board certification or board eligibility in your specialty.
- Texas medical license (or ability to obtain prior to start).
- AHA BLS certification required; ACLS (or specialty equivalent) required within 90 days for acute care.
- Active DEA and DPS registrations.
- Correctional health care experience is a plus, but not required.
- Spanish/English bilingual preferred.
What We're Looking For
- A physician with a strong sense of social responsibility and a desire to serve underserved and justice-involved populations.
- Ability to adapt medical care to patients with diverse cultural, psychosocial, and developmental needs.
- Skilled communicator who can work effectively with patients, staff, and correctional personnel.
- A commitment to quality, safety, and compassionate care even in challenging environments.
Why Join University Health?
At University Health, you'll find more than a job—you'll find a calling. Working in detention health care offers:
- The chance to positively impact vulnerable populations.
- A supportive, team-based work environment.
- Opportunities for teaching and mentorship through our academic partnerships.
- Competitive compensation and a comprehensive benefits package.
University Health is seeking a compassionate and skilled Physician to provide high-quality medical care to individuals housed in the Bexar County Adult Detention Center. This unique role offers the opportunity to serve a population with complex health needs in a secure environment while working within one of Texas' leading academic health systems.
You'll be part of a multidisciplinary team committed to improving the health and well-being of patients while ensuring safe, ethical, and professional medical care.
Key Responsibilities
- Provide comprehensive health care services within your specialty to individuals housed in the Bexar County Jail.
- Diagnose, treat, and manage acute and chronic medical conditions for incarcerated patients.
- Collaborate with nursing staff, mid-level providers, and correctional officers to deliver safe and effective patient care.
- Accurately document patient encounters and submit billing/coding information in compliance with policies.
- Participate in quality improvement activities, chart reviews, and peer audits.
- Support teaching and training opportunities with UT Health San Antonio medical students and residents.
- Participate in a rotational on-call schedule.
- Ensure care delivery aligns with University Health's mission, values, and established correctional health standards.
Qualifications
- MD or DO from an accredited medical school.
- Completion of an ACGME-accredited residency program.
- Board certification or board eligibility in your specialty.
- Texas medical license (or ability to obtain prior to start).
- AHA BLS certification required; ACLS (or specialty equivalent) required within 90 days for acute care.
- Active DEA and DPS registrations.
- Correctional health care experience is a plus, but not required.
- Spanish/English bilingual preferred.
What We're Looking For
- A physician with a strong sense of social responsibility and a desire to serve underserved and justice-involved populations.
- Ability to adapt medical care to patients with diverse cultural, psychosocial, and developmental needs.
- Skilled communicator who can work effectively with patients, staff, and correctional personnel.
- A commitment to quality, safety, and compassionate care even in challenging environments.
Why Join University Health?
At University Health, you'll find more than a job—you'll find a calling. Working in detention health care offers:
- The chance to positively impact vulnerable populations.
- A supportive, team-based work environment.
- Opportunities for teaching and mentorship through our academic partnerships.
- Competitive compensation and a comprehensive benefits package.
