- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Utilizing key principles of utilization management , the Utilization Review Specialist will perform prospective, ... Preferred **Experience:** 5 years Clinical nursing experience. 2 years Care Management and/or Utilization Management . **Preferred Qualifications:** + … more
- Cognizant (Washington, DC)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and utilization management experience with managed health care plan . 3 years' ... **Schedule:** Monday to Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- Sharecare (Washington, DC)
- …everyone. To learn more, visit www.sharecare.com. **Job Summary:** Data Entry Specialist is responsible for accurately inputting patient information into Sharecare's ... (EMR) platforms. This role requires keen attention to detail, efficient data management , and strict adherence to HIPAA compliance standards, supporting the Release… more
- CareFirst (Baltimore, MD)
- …care. + Reviews the performance of provider partners based on utilization , trends, and quality metrics to develop rate/reimbursement solutions. Ensures that ... geographically competitive, offers broad access, and meets cost and trend management objectives. **Regulatory and Healthcare Landscape** + Monitors and remains… more
- Elevance Health (Washington, DC)
- **Medical Management Specialist I** **Location:** Washington, DC. This role requires associates to be in-office 4 days per week, fostering collaboration and ... law. **Schedule:** Monday-Friday 8:00AM-5:00PM or 8:30AM-5:30PM EST The **Medical Management Specialist I** will be responsible for...and determines appropriate area to refer or assign case ( utilization management , case management , QI,… more
- Canon USA & Affiliates (Washington, DC)
- **CT Clinical Applications Specialist - req1559** **OVERVIEW** This position is the project manager for the final implementation for clinical applications training ... the sales and installation is complete, the Clinical Applications Specialist takes charge of the process, and works with...and technologists at each location to assure their best utilization of CMSU products and services. + Consult with… more
- Evolent (Washington, DC)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to ... on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical...Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to… more
- Ryder System (Washington, DC)
- …and questions from customers, and is a highly organized professional with management experience who can ensure the most efficient call center operations while ... policy, procedures, and technology programs to support contact center management + Ensure service is delivered in line with...(Tier 1 Call Center Representatives and Tier 2 Functional Specialist ). Ensure contact center staff have the training and… more
- Marriott (Bethesda, MD)
- …**Schedule** Full Time **Located Remotely?** Y **Position Type** Management **Expiration Date:** 10/29/2025 This is a temporary position. ... any of the following cloud products: OCI, Benefits, Compensation, Payroll, Absence Management , Talent Management , Learning or Recruiting Cloud. . Strong… more
- ASM Research, An Accenture Federal Services Company (Washington, DC)
- …not limited to software distribution, backups, performance measurement, tuning, license and asset management to allow automated as well as remote systems ... on the project in a senior administrator capacity. Considered a technical specialist in a variety of IT administrator disciplines. + Configure, monitor, and… more