- Humana (Washington, DC)
- **Become a part of our caring community and help us put health first** The Utilization Management (UM) Director , Clinical Strategy and Practice for Medicaid ... of how organization capabilities interrelate across the function or segment. The Utilization Management (UM) Director , Clinical Strategy and Practice… more
- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth...in a fast-paced environment. The Clinical Care Reviewer - Utilization Management will also be counted upon… more
- Elevance Health (Chantilly, VA)
- …of licensure the District of Columbia is required. **Preferred Qualifications:** + Utilization Management /Review in managed care strongly preferred. + Inpatient ... RN Utilization Review Nurse (Washington DC Medicaid) JR149756 **Location**...is located at 609 H. Street NE. The **Medical Management Nurse** is responsible for review of the most… more
- Evolent (Washington, DC)
- …classes as needed for new hires to educate and train on Utilization management system and Field Medical Director process, standards and resources. + Acts as ... for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of...reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + Strong partnership with… more
- Evolent (Washington, DC)
- …impact on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your ... Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. +… more
- Humana (Washington, DC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on medical background and reviews health claims....with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Washington, DC)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Humana (Washington, DC)
- …Medical Director , depending on size of team or line of business. The Medical Director conducts Utilization Management of the care received by members in ... community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Washington, DC)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Washington, DC)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- United Therapeutics (Washington, DC)
- …is innovative and inspiring where you can truly make a difference. The Regional Field Director , RNS Program Management serves as a director of all clinical ... the commercial non-promotional team. In addition, the Regional Field Director , RNS Program Management will: + Serve...initiation of a UT product, adverse effect mitigation, device utilization , and dosing upon request + Support the Clinical… more
- PenFed Credit Union (Mclean, VA)
- …it's about being a part of the PenFed family. PenFed is hiring a (Hybrid) Director , IT Management Controls at our Tysons, Virginia location. The primary purpose ... and generalists to generally promote and provide strong governance and management practices across PenFed's IT Division. This position directly supports the… more
- Grant Thornton (Arlington, VA)
- …to share strategy, to implement process improvements and to roll out capacity management strategies to maximize utilization and drive operational excellence + ... Grant Thornton is seeking an Advisory Capacity & Resource Management (C&RM) Leader to join the team. Approved office...on yearly budget planning for headcount, gross charge hours, utilization , and leverage. You will lead your team to… more
- EAB (Washington, DC)
- …recent awards. For more information, visit our Careers page. The Role in Brief: Associate Director , K-12 Account Management + Do you want to make a difference in ... for finding solutions in complex or difficult situations? The Associate Director is responsible for developing and maintaining relationships with K-12 institutions… more
- Humana (Washington, DC)
- …interpretation skills, with prior experience participating in teams focusing on quality management , utilization management , case management , discharge ... Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management . + Utilization management experience in a… more
- Evolent (Washington, DC)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. + ... Surgery you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Evolent (Washington, DC)
- …Senior Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support. . ... Oncology, you will be a key member of the utilization management team. We can offer you... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National … more
- Somatus (Falls Church, VA)
- …engagement opportunities + And more! $5k SIGN ON BONUS! The Associate Director of Out-Patient Services supports Somatus mission, vision, values, and customer service ... + Collaborates with the SVP of Dialysis Services/Clinical Services Director of IP/OP Dialysis Operations regarding providing high-quality patient care… more
- CBRE (Vienna, VA)
- Business Development Senior Director , Enterprise Occupier Solutions Job ID 208590 Posted 28-Feb-2025 Service line GWS Segment Role type Full-time Areas of Interest ... **The client-facing title for this role is Senior Managing Director , Business Development** We are seeking a Senior ...and grow activities in integrated Real Estate and Facilities Management outsourcing pursuits, and will lead interactions in a… more
- Brookings (Washington, DC)
- …that leads to new ideas for solving problems facing society at the local, national and global level. We bring together leading experts in government and academia ... and fairness. OFS is comprised of Accounting, Financial Planning and Management , Financial Operations and Investments. Position Location : This position is… more