- Monte Nido (Clifton, VA)
- …may substitute leadership experience elsewhere. + Working knowledge of admissions and intake, Utilization Review , and 3rd party or insurance payers. + Previous ... + Knowledge of Diversity, Equity and Inclusion practices + Employee selection and performance management experience are a plus. + Must hold a Master's degree in a… more
- Parexel (Washington, DC)
- …mitigations and drive resolution with cross-functional stakeholders as part of the Risk Management Plan. + Review and analyze metrics to derive meaningful ... Leadership:** + Manage and coordinate the integration and utilization of all ancillary systems. + Highlight issues/risks to...project-level resourcing of staff and staff assignments. + Regularly review and update Data Management resources to… more
- NuAxis Innovations (Washington, DC)
- **IT Asset Management Lead** Location **Washington, DC** \# of openings **1** Salary Range (Min-Max) **00** **We are a federal IT company on a mission to make ... join our team NOW! We are currently seeking a talented and motivated **IT Asset Management Lead** for a Full-Time position. The IT Asset Management Lead is… more
- Battelle Memorial Institute (Fort Belvoir, VA)
- …programs, with additional applications in military engineering, DoD installation management , and USACE projects. **Deliverable:** The primary deliverable for this ... file sizes, and high utility in operational contexts. **Responsibilities** + Review scientific literature to identify and implement appropriate research methods. +… more
- Battelle Memorial Institute (Chantilly, VA)
- …include strategic planning, teaming, capture, requests for proposal (RFP) review , proposal development and submission, contract structure and negotiation, and ... contract management and close-out activities. + Reviews and approves acquisition...on a continuous basis the DCMA Contractor Purchasing System Review (CPSR) and final certification and approval of Battelle's… more
- Red River (Chantilly, VA)
- …to lead a portfolio of managed services accounts within the Property Management and Manufacturing verticals. Proven leader who thrives under scrutiny, takes full ... and grow a portfolio of SMB to enterprise-level accounts within Property Management and Manufacturing vertical. . Drive vertical strategy execution, aligning Red… more
- Battelle Memorial Institute (Arlington, VA)
- …within legal and professional parameters + Knowledge and skill in using pre-established utilization review criteria to recognize and report actual or potential ... by a recognized certifying organization, ie, Commission for Case Management Certification or American Nurse Credentialing Center + At...programs for equal treatment of all staff and full utilization of all qualified employees at all levels within… more
- Parexel (Washington, DC)
- …the intent of the study concept and make informed recommendations based on scientific review and information available at the time of the request + Ability to ... as required to ensure viability output fulfills the teamsteam's requirements. + Utilization of tools (eg Medidata, Symphony (Real World Evidence)) to generate data… more
- Red River (Washington, DC)
- …Residency Services Manager will be responsible for our residents' growth and operational management in the field full-time for the project's duration for any given ... field operatives working at a full time, or 100% utilization less time off. + Leverage SKU-based residency services...of 30% GP. + Build and manage Residency Project Management Office to manage customer expectations around delivery which… more
- Battelle Memorial Institute (Chantilly, VA)
- …The **Vice President, Cyber Business Line** is responsible for the organization, management , and business performance of Battelle's cyber business portfolio. The VP ... decision processes; establish pricing policy and practices. + Drive effective project management to ensure all projects are scoped, expensed, and delivered as… more
- GCG (Washington, DC)
- …Drive change management and user training to ensure effective system utilization across the organization + Monitor system performance and user feedback to ... Business Partners to support talent reviews, succession planning, and performance management , while managing and facilitating key development programs. You will… more
- Battelle Memorial Institute (Arlington, VA)
- …maintaining detailed medical records, possibly supervising trainees, performing case management , and engaging in military-specific training and activities as ... current notes in the electronic medical records of all patients contacted for review by the managing physician + Routinely staff difficult cases with the referring… more
- AmeriHealth Caritas (Washington, DC)
- …BONUS** **Role Overview:** Under the direction of a supervisor, the Clinical Care Reviewer - Utilization Management evaluates medical necessity for inpatient ... overtime, and weekends based on business needs. **Responsibilities:** + Conduct utilization management reviews by assessing medical necessity, appropriateness of… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are...who will assist in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The… more
- Cognizant (Washington, DC)
- …. Educational background - Registered Nurse (RN) . 2-3 years combined clinical and/or utilization management experience with managed health care plan . 3 years' ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited to referral,...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Washington, DC)
- …RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability ... Therapy, DME, Cardiac or Orthopedic procedures + Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/Medicare… more
- Humana (Washington, DC)
- …put health first** The UM Administration Coordinator contributes to administration of utilization management . The UM Administration Coordinator 2 performs varied ... new systems (proficient to advanced) **Preferred Qualifications** + Experience with Utilization Review and/or Prior Authorization, preferably within a managed… more
- Evolent (Washington, DC)
- …Reviewer , Interventional Pain Management , you will be a key member of the utilization management team. We can offer you a meaningful way to make a ... Will Be Doing:** + Serve as the Physician Clinical Reviewer for Interventional Pain Management , reviewing cases... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
- Highmark Health (Washington, DC)
- …:** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and ... and DOL regulations at all times. In addition to utilization review , the incumbent participates as the...member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on cases,… more
- Evolent (Washington, DC)
- …the mission. Stay for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready ... on patient care in a non-clinical setting? Join our Utilization Management team as a Field Medical... and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National… more
