Current jobs related to Clinical Review Specialist - Harlingen, Texas - Prime Healthcare

  • Utilization Review Specialist

    7 days ago

    Harlingen, Texas, United States Summit BHC Full time

    About the Role:The Utilization Review Specialist will be responsible for reviewing assigned admissions, continued stays, and discharge planning according to approved clinically valid criteria. This role will ensure that all utilization review activities are conducted in a timely and efficient manner, with a focus on improving the collection, reimbursement,...

  • Clinical Documentation Specialist

    2 weeks ago

    Harlingen, Texas, United States Prime Healthcare Full time

    OverviewHarlingen Medical Center, a member of Prime Healthcare, is seeking a skilled Clinical Documentation Specialist to join our team. As a Clinical Documentation Specialist, you will play a critical role in ensuring the accuracy and completeness of patient medical records.ResponsibilitiesConduct clinically based concurrent and retrospective reviews of...

  • Clinical Documentation Specialist

    2 weeks ago

    Harlingen, Texas, United States Harlingen Medical Center Full time

    Job SummaryClinical Documentation Specialist - HMC Medical RecordsJob ResponsibilitiesAs a Clinical Documentation Specialist at Harlingen Medical Center, you will be responsible for conducting clinically based concurrent and retrospective reviews of inpatient medical records to evaluate the clinical documentation is reflective of quality of care outcomes and...

  • Clinical Documentation Specialist

    2 weeks ago

    Harlingen, Texas, United States Prime Healthcare Full time

    Job SummaryWe are seeking a highly skilled Clinical Documentation Specialist to join our team at Harlingen Medical Center, a member of Prime Healthcare. As a Clinical Documentation Specialist, you will play a critical role in ensuring the accuracy and completeness of patient medical records. Your attention to detail and strong analytical skills will be...

  • Clinical Documentation Specialist

    3 weeks ago

    Harlingen, Texas, United States Prime Healthcare Full time

    OverviewHarlingen Medical Center, a member of Prime Healthcare, is seeking a highly skilled Clinical Documentation Specialist to join our team. As a Clinical Documentation Specialist, you will play a critical role in ensuring the accuracy and completeness of patient medical records. Your attention to detail and strong clinical knowledge will enable you to...

  • Clinical Documentation Specialist

    2 weeks ago

    Harlingen, Texas, United States Harlingen Medical Center Full time

    Job SummaryClinical Documentation Specialist is responsible for conducting clinically based concurrent and retrospective reviews of inpatient medical records to evaluate the clinical documentation is reflective of quality of care outcomes and reimbursement compliance for acute care services provided. This role will work closely with the medical staff to...

  • Clinical Utilization Specialist

    4 weeks ago

    Harlingen, Texas, United States Summit BHC Full time

    Job Title: Clinical Utilization SpecialistAt Summit BHC, we are seeking a highly skilled Clinical Utilization Specialist to join our team. As a Clinical Utilization Specialist, you will play a critical role in ensuring that our patients receive the necessary care and services to achieve optimal health outcomes.Key Responsibilities:Conduct thorough reviews of...

  • Clinical Nurse Specialist

    1 week ago

    Harlingen, Texas, United States Prime Healthcare Full time

    OverviewHarlingen Medical Center, a member of Prime Healthcare, is committed to delivering high-quality patient care. As a Clinical Nurse Specialist, you will play a vital role in ensuring the quality and resource management of patients admitted to our facility.ResponsibilitiesAs a Clinical Nurse Specialist, you will be responsible for promoting cost...

  • Clinical Laboratory Specialist

    1 week ago

    Harlingen, Texas, United States Harlingen Medical Center Full time

    Job Summary:Harlingen Medical Center is seeking a skilled Clinical Laboratory Specialist to join our team. As a Clinical Laboratory Specialist, you will be responsible for performing a wide variety of laboratory procedures, including Hematology, Blood Bank, Chemistry, Urinalysis, Coagulation, Microbiology, Immunology, and other...

  • Clinical Specialist

    7 days ago

    Harlingen, Texas, United States CosignMed Full time

    CosignMed Clinical Specialist Job DescriptionAs a Clinical Specialist at CosignMed, you will play a vital role in providing technical support to physicians, surgical staff, and institutions. Your primary responsibility will be to cover Men's Health surgical procedures on a per diem basis, requiring a flexible schedule to support cases.Key...

  • Clinical Laboratory Specialist

    2 weeks ago

    Harlingen, Texas, United States Harlingen Medical Center Full time

    About Harlingen Medical CenterHarlingen Medical Center is a Level IV Trauma Designated hospital that specializes in providing high-quality patient-focused care to the residents of Western Cameron County. Our team of dedicated professionals is committed to our core values of quality, compassion, and community.Job SummaryWe are seeking a skilled Clinical...

  • Clinical Admissions Specialist

    2 weeks ago

    Harlingen, Texas, United States Summit BHC Full time

    Job SummaryWe are seeking a highly skilled and compassionate Clinical Admissions Specialist to join our team at Palms Behavioral Health. As a key member of our admissions team, you will play a critical role in facilitating the intake process, ensuring seamless transitions for patients, and providing exceptional customer service.Key ResponsibilitiesFacilitate...

  • Clinical Laboratory Specialist

    2 weeks ago

    Harlingen, Texas, United States Prime Healthcare Full time

    OverviewHarlingen Medical Center, a member of Prime Healthcare, is a Level IV Trauma Designated hospital that specializes in providing high-quality patient care. We are seeking a skilled Clinical Laboratory Specialist to join our team of dedicated professionals.ResponsibilitiesPerform a wide variety of laboratory procedures, including waived, moderate, and...

  • Behavioral Health Specialist II

    1 week ago

    Harlingen, Texas, United States Health & Human Services Comm Full time

    Job DescriptionJoin Health & Human Services Comm as a Behavioral Health Specialist II and contribute to the delivery of exceptional care to individuals with intellectual and developmental disabilities.Key ResponsibilitiesProvide advanced clinical and supervisory services, working under minimal supervision with extensive latitude for initiative and...

  • Echocardiogram Specialist

    2 weeks ago

    Harlingen, Texas, United States Trusted Resource Associates Full time

    Trusted Resource Associates (TRA) is seeking a skilled Echocardiogram Specialist to join their team in a local contract position in Texas.Job Description & RequirementsSpecialty: Echocardiogram SpecialistDiscipline: Allied Health ProfessionalJob Type: Local ContractShift: 8 hours, nightsHours: 40 hours per weekDuration: 13 weeksAs an Echocardiogram...

  • Travel Echocardiography Specialist

    2 weeks ago

    Harlingen, Texas, United States Trusted Resource Associates Full time

    Trusted Resource Associates (TRA) is seeking a skilled Echocardiography Specialist to join their team in a travel position in Texas.Job Description & RequirementsSpecialty: EchocardiographyDiscipline: Allied Health ProfessionalDuration: 13 weeks40 hours per weekShift: 8 hours, nightsEmployment Type: TravelAs an Echocardiography Specialist, you will perform...

  • Nurse Specialist

    2 weeks ago

    Harlingen, Texas, United States Baptist Health System - San Antonio TX Full time

    Baptist Health System - San Antonio TX is seeking a skilled Nurse Specialist to provide high-quality care to patients in the Oncology department.Job Description & RequirementsSpecialty: OncologyDiscipline: Nurse SpecialistDuration: Ongoing36 hours per weekShift: 12 hoursEmployment Type: StaffUp to $20,000 Sign-On bonus for experienced Nurse...

  • Traveling Clinical Technologist

    2 weeks ago

    Harlingen, Texas, United States OneStaff Medical Full time

    Unlock Your Career PotentialWe are OneStaff Medical, a nationally-recognized and independently-owned staffing firm dedicated to helping you find your dream assignment. With a work ethic forged in the Midwest, we stand by your side and provide the support you need to succeed.The Opportunity:We are seeking a skilled Clinical Technologist to join our team of...

  • Medical Billing Specialist

    2 weeks ago

    Harlingen, Texas, United States Prime Healthcare Full time

    Job SummaryPrime Healthcare is seeking a skilled Medical Billing Specialist to join our team. As a Medical Billing Specialist, you will be responsible for accurately and efficiently posting incoming payments to patient accounts, reconciling accounts daily, and applying payments to patient accounts. You will also be responsible for reviewing and performing...

  • Clinical Therapist

    2 weeks ago

    Harlingen, Texas, United States Summit BHC Full time

    About the Role:The Clinical Therapist is a vital member of the multidisciplinary team at Summit BHC, responsible for providing direct clinical services to patients and their families. The primary focus is on completing comprehensive psychosocial assessments, developing and implementing individualized treatment plans, and facilitating psycho-educational...

Clinical Review Specialist

2 months ago

Harlingen, Texas, United States Prime Healthcare Full time

Position Overview

We are seeking a dedicated professional to join our esteemed organization, Prime Healthcare, where we prioritize excellence, empathy, and community engagement. Our facility, recognized for its Level IV Trauma designation, offers a wide array of services including Cardiovascular Care, Emergency Response, Neuroscience, Orthopedics, Radiology, Rehabilitation, and Surgical Services. For over 15 years, we have been committed to delivering exceptional healthcare to our community.

Our organization values diversity and is committed to providing equal opportunities, ensuring a workplace that is fair and inclusive for all employees.

Key Responsibilities

- Conduct thorough clinical evaluations of patient medical records in partnership with the Chief Medical Officer (CMO)
- Actively engage in Case Management and Utilization Review (UR) meetings
- Provide ongoing education to various departments
- Review patient charts to confirm adherence to clinical admission and treatment standards
- Manage and respond to requests for records from payers and fiscal intermediaries
- Offer updates regarding open and closed accounts for Utilization Review and Case Management reporting
- Make independent decisions grounded in sound judgment
- Stay updated on federal, state, and intermediary regulations for varying levels of care
- Facilitate discharge referrals as requested by clinical staff, fiscal intermediaries, patients, and families
- Perform additional duties as assigned

Qualifications

Education and Experience Requirements

Required:

  • Master of Public Health (MPH) or a relevant post-graduate degree in healthcare
  • Medical or Dental Graduate
  • Knowledge of Clinical Pathophysiology and Pharmacology

Preferred:

  • ECFMG Certification or a Bachelor's degree from a US-accredited institution in Health and Human Services
  • Experience in Utilization Review or Case Management
  • A minimum of 1 year of clinical experience in acute care environments
  • Strong written and verbal communication skills
  • Exceptional critical thinking and interpersonal skills
  • Able to work independently in a fast-paced setting
  • Proficient in computer data entry, with a typing speed of at least 35 wpm