- Fresenius Medical Center (Alexandria, VA)
- …Classification of Disease (ICD) coding. + Manages clinic financials including efficient utilization of supplies or equipment and regular profits and loss review. + ... + Reports changes in patient status regarding any clinical, insurance, or travel and transportation issues. STAFF: + Participates in the selection and hiring… more
- Fresenius Medical Center (Washington, DC)
- **PURPOSE AND SCOPE:** The professional registered nurse Outpatient RN CAP 2 may be an entry level designation into the Clinical Advancement Program (CAP) ... for new employees who meet the RN CAP 2 criteria or attained through...the Clinical Educator, Preceptor or in collaboration with other Registered Nurses. + Performs ongoing, systematic collection and analysis… more
- Sedgwick (Washington, DC)
- …and consult review; and two (2) years of experience in daily application of nurse auditing, utilization review and bill review. **Skills & Knowledge** + ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer RN Bill Review **PRIMARY PURPOSE** **:** To review hospital and professional… more
- Highmark Health (Washington, DC)
- …+ Licensed Marriage and Family Therapist (LMFT) + Licensed Behavior Specialist + Registered Nurse . **Preferred** + None **SKILLS** + Working knowledge of ... **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of health care… more
- Humana (Washington, DC)
- …_(Washington DC, MD, WV, KY, TN & NC)_ **.** + An active, unrestricted, Registered Nurse ( RN ) license or Licensed Mental Health Professional (LMHP) ... policies regarding other departmental areas such as medical management, utilization management, population health and quality. + May require...be screened for TB. + Must be able to travel throughout the commonwealth of Virginia. + This role… more
- Somatus (Mclean, VA)
- …Prior clinical experience in dialysis or renal care setting is a must. * Current Registered Nurse compact state licensure and other states as deemed necessary by ... Assist Directors of Quality and UM on quality and utilization audits as assigned, including targeted audits as requested...and by complying with all requirements for continuing education. Travel (up to 25%) to local renal care providers… more
- Somatus (Mclean, VA)
- …Physician's clinical supervision. + Partner with a multidisciplinary team, including RN case managers, social workers, clinical pharmacists, registered ... ESKD transitions where indicated. + Oversee a local state-based team of nurse practitioners who provide direct virtual and in-home prescriptive clinical care under… more