- WTW (Arlington, VA)
- …in the North American market to join as a Property & Casualty (P&C) Associate Director in our Insurance Consulting and Technology (ICT) practice. You will have ... full potential. In this role you will collaborate with our team of pricing, claims , distribution, product management, underwriting and claims experts to sell and… more
- Humana (Richmond, VA)
- …to drive improvements in quality and/or reductions in total cost of care + Scorecard creation and reconciliation of provider performance based on contractual ... Qualifications:** + Bachelor's Degree + 3-5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care +… more
- CareFirst (Reston, VA)
- …makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while ... in projects. **ESSENTIAL FUNCTIONS:** + Audits assigned function (service, claims , enrollment) for accuracy, benefit payment, contract interpretation, and compliance… more
- Marriott (Richmond, VA)
- …as injured worker advocate assisting them to set goals and participate in their care . + Recommend referral to Associate Resource Line as needed. + Coordinate ... **Additional Information** Nurse CARE Manager ( CARE - Coordinated Action...jurisdiction. This position is responsive to Marriott's associates, Marriott Claims Services, business units, Risk Management and community health… more
- Humana (Richmond, VA)
- …hands-on experience with healthcare data such as medical, behavioral, pharmacy claims data, financial, social and demographic data; demonstrated innovative and ... experience in health insurance domain, familiarity with products, providers and claims processing. + Experience with Data Warehousing (Azure/SQL/Synapse), ETL (Azure… more
- Humana (Richmond, VA)
- …more years of experience with CMS and/or AHCA compliance + 2 or more years Claims experience + 2 or more years Audit and/or Financial Recovery experience + SQL ... structure and design **Preferred Qualifications** + Direct experience working with Medicare claims + Working knowledge of CPT, ICD10 and HCPC + Provider contract… more
- Humana (Richmond, VA)
- …to business & customers we serve using the latest in software technology? Our claims services team is best positioned in building modernized claims eco systems ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more
- University of Virginia (Charlottesville, VA)
- …build toward the management of roughly 35 LVAD patients, coordinating outpatient care , addressing patient phone calls and portal messages, and seeing 3-5 patients ... with transthoracic echocardiography or right heart catheterizations, and perform wound care /wound management for the driveline exit site. As an academic medical… more
- Elevance Health (Richmond, VA)
- …Practice Enablement Clinician** **Location** : This position will work a hybrid model ( remote and office). The ideal candidate will live within 50 miles from one ... key strategic solutions that involve practice collaboration and enablement to improve member care quality and value. Serves as a strategic solution lead for Oncology… more
- Humana (Richmond, VA)
- …the State fiscal agent or other FSSA contractors regarding encounter claims submissions, capitation payment, member eligibility), enrollment and other data ... continuously improving consumer experiences + Virginia State Resident While this is a remote opportunity, it will require the willingness to travel to the market… more
- CVS Health (Richmond, VA)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary This...and affordable. Position Summary This is a full time remote teleworker position in Virginia. The Case Manager RN… more
- CVS Health (Richmond, VA)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Position Summary This is a full time… more
- CVS Health (Richmond, VA)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Monday-Friday 8am-5pm EST. Position Summary… more
- CVS Health (Richmond, VA)
- …of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at ... accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. Monday-Friday 8am-5pm EST. Position Summary… more
- Humana (Richmond, VA)
- …The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems of ... of established clinical experience + Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products...protect member PHI / HIPAA information This is a remote position **Scheduled Weekly Hours** 40 **Pay Range** The… more
- Humana (Richmond, VA)
- …+ Intermediate to advanced experience in programming, analytical work, and with claims data. + Familiarity or prior experience with data governance and literacy. ... requirements and guidelines. **Additional Information** + **Travel** : None + **Workstyle:** Remote + **Core Workdays & Hours:** Typically, 8-5 pm Monday - Friday;… more
- Humana (Glen Allen, VA)
- …volumes of data + Good understanding of healthcare data eg, member, provider, claims and clinical data + Experience and understanding of data governance practices ... **Location/Work Style:** Hybrid Office in Louisville, KY is preferred but open to Remote US as well **Why Humana?** At Humana, we know your well-being is… more
- Humana (Richmond, VA)
- …for complex accounts + Experience analyzing a wide variety of health or claims related data **Additional Information** **Why Humana?** At Humana, we know your ... space lacking ongoing interruptions to protect member PHI / HIPAA information \#LI- Remote **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below… more