- Battelle Memorial Institute (Arlington, VA)
- …with the referring provider, behavioral health consultant and/or psychiatry consultant + Perform case management functions **Key Qualifications** + Master ... and Analytics (HRA) business line is seeking a highly motivated, full-time **Licensed Clinical Social Worker (LCSW)** to join our team in support of our government… more
- CVS Health (Washington, DC)
- … clinical skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Conduct clinical reviews for adult ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
- CVS Health (Annapolis, MD)
- …And we do it all with heart, each and every day. **Position Summary** Utilization Management is a 24/7 operation and work schedules will include weekends, ... holidays, and evening hours. * Utilizes clinical experience and skills in a collaborative process to...and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and… more
- Guidehouse (Arlington, VA)
- …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and operational improvement across business and purchased services, supply cost, and clinical supply utilization at client provider organizations. Our team of… more
- Guidehouse (Arlington, VA)
- …efficiency, quality, and reliability. Areas of expertise include care and utilization management , throughput, post-acute care and readmissions, pharmacy and ... and operational improvement across business and purchased services, supply cost, and clinical supply utilization at client provider organizations. Our team of… more
- CareFirst (Baltimore, MD)
- …**Experience:** 5 years experience in business development, operational technology support, Utilization Management (UM) operations, Clinical Product ... role will focus specifically on optimizing end-to-end business processes within Utilization Management . **ESSENTIAL FUNCTIONS:** + Provide deep subject matter… more
- Highmark Health (Washington, DC)
- …needs and the analytical technology team. The Senior Decision Support Consultant will leverage technical, analytical, and business expertise to design, develop, ... while also being capable of developing technical solutions. The consultant will act as a senior resource within the...the impact of Highmark's business decisions on Informatics, personnel utilization , and the use and planning of technology. The… more
- Deloitte (Washington, DC)
- Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk ... for both formal and informal education of physicians, CDI team, health information management and other clinical staff + Develop in-service education tools as… more
- CareFirst (Baltimore, MD)
- …or similar clinical experience OR 5 years experience in Medical Review, Utilization Management or Case Management at CareFirst BlueCross BlueShield, or ... **Resp & Qualifications** **PURPOSE:** The Clinical Appeals Supervisor directs and coordinates the accurate...regulatory and accreditation requirements, understanding of appeals process and utilization management , and systems software used in… more
- Johns Hopkins University (Baltimore, MD)
- …at Homewood; all offer in-person and telehealth options. The Associate Director of Clinical Services serves as a senior consultant to clinicians and ... practitioner with strong organizational and leadership skills, and experience supporting clinical service delivery models, data management , and reporting. The… more
- Immigration and Customs Enforcement (Washington, DC)
- …Manager works under the general supervision of the IHSC Regional Behavioral Health Clinical Consultant within their area of responsibility. The incumbent plans ... of command. Perform other duties and responsibilities as assigned. 16. Utilization review/ management for inpatient behavioral health hospitalization for IHSC.… more
- Johns Hopkins University (Baltimore, MD)
- …of acute and long-term effects of radiation and provides accurate and timely management for such side effects. + Provides education to patient and family members ... + Conducts telehealth visits as appropriate for follow-up care, symptom management , or triage, ensuring timely communication and documentation in the EMR.… more
- Mallinckrodt Pharmaceuticals (Washington, DC)
- …able to show documented success as a top producer using superior clinical selling skills, while effectively managing their territory operating within all compliance ... and procedures, as a results-oriented sales person, business partner and consultant . Develop strategically targeted, accounts and specific business plans that… more
