- AmeriHealth Caritas (Washington, DC)
- …Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient and outpatient services, ... in a fast-paced environment. The Clinical Care Reviewer - Utilization Management will also be counted upon...document and assess patient cases. + Strong understanding of utilization review processes, including medical necessity criteria,… more
- Sharecare (Washington, DC)
- …total healthcare management and ensure cost effective, appropriate resource utilization and quality outcomes. The Clinical Registered Nurse is also ... the participants and their Primary Care Provider according to the disease management program intervention guidelines. A Clinical Registered Nurse is supervised… more
- Fresenius Medical Center (Clinton, MD)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Immigration and Customs Enforcement (Washington, DC)
- …Service Corps (IHSC). The incumbent will report directly to the Medical Case Management Program Manager (MCMPM). This is a non-supervisory position. This position is ... communicating with RCDs for community referrals. Collaborate with Health Plan Management Unit for all hospitalization concurrent visits monitoring. Utilize unified… more
- Treasury, Departmental Offices (Washington, DC)
- …and utilization of workforce statistics, HR IT solutions, project management and process improvement techniques. - working with data to identify data ... Department of the Treasury in Washington, DC. As a Management and Program Analyst, you will be an expert...be required to comply with federal ethics laws. A review of financial or other interests may be conducted… more
- Immigration and Customs Enforcement (Washington, DC)
- …(Nurse Practitioner/Physician Assistant), preferably in correctional or detention setting. Case management and utilization review experience preferred. ... AOR and formally reports site visit findings to ICE/ERO and IHSC for review and approval of medical compliance findings related to ICE National Detention Standards… more
- Sunrise Senior Living (Arlington, VA)
- …discounts at higher education institutions * Higher wage rates * Changes in management * Improved health and wellness benefits starting January 2025 The Director of ... Nursing is responsible for providing leadership and management to the skilled nursing operations. Responsible for planning,...the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team… more
- Sunrise Senior Living (Bowie, MD)
- …The Director of Nursing Services is responsible for providing leadership and management to the skilled nursing operations. Responsible for planning, organizing and ... position. Clinical Care Delivery Operations + Directs, supervises the management of the team members in the skilled nursing...the highest quality standards for well-being. + Ensures proper utilization of the Resident Care Plan by all team… more
- Customs and Border Protection (Washington, DC)
- …Accountability, and Evaluation Division; International Engagement and Incident Management Division; Trade Intelligence Division, and Trade Investigations Division. ... procedures and regulations, utility, technical adequacy, timeliness and effective utilization of resources. Identifying operating problems, conflicting priorities, program… more
- Architect of the Capitol (Washington, DC)
- …availability of adequate resources consistent with project objectives; Assisting with the management of the utilization of resources, justifies plans and ... the Capitol (AOC), Office of the Chief Engineer, Project Management Division is seeking an exceptional General Engineer or...of General Schedule Positions. It is available for your review on the OPM web site at OPM qualification… more
- Architect of the Capitol (Washington, DC)
- …management operations, timber management , wildland fire science or fire management , utilization of forest resources, forest regulation, recreational land ... possess and maintain a valid state driver's license. Arboretum Management - (Duties quoted below are at the GS-13...of General Schedule Positions. It is available for your review on the OPM web site at http://www.opm.gov/qualifications. In… more
- Lincoln Financial (Washington, DC)
- …Care, Orthopedics, Coronary Care, , Trauma , Disability, Workman's comp or case management or Utilization review **Application Deadline** **What's it like ... this role you will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information to clarify diagnoses,… more
- Center for Global Development (Washington, DC)
- …salary allocations. + Produce financial reports, charts and visualizations for senior management and the biannual Board of Directors meetings. + Develop proactive ... (CGD's accounting firm, auditor, bank, and investment professionals). Grants/Contracts Management + Establish procedures to manage all financial requirements… more
- KBR (Washington, DC)
- …compliance in meeting care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... risk management issues in order to improve practice, and ensure...; full , active, and unrestricted license as a Registered Nurse or Licensed Clinical Social Worker in one… more
- KBR (Washington, DC)
- …compliance in meeting care goals. + Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and ... risk management issues in order to improve practice, and ensure...Current licensure; full, active, and unrestricted license as a Registered Nurse or Licensed Clinical Social Worker in one… more
- Trinity Health (Silver Spring, MD)
- …in the development and management of quality, risk, and utilization review processes. Demonstrated leadership, communication, and analytical skills. Able ... the radiologist physician determines the appropriate course of treatment and advises management on clinical matters and the results of any external audits, clinical… more
- Maryland Department of Transportation (Anne Arundel County, MD)
- …duties in support of project development, highway infrastructure, asset management , construction projects and condition assessments. In a learning capacity, ... testing/evaluation in the laboratory as well as in the field, utilization of materials test results in pavement/geotechnical design, performing hands-on forensic… more