- Luke Staffing (Bethesda, MD)
- …tasks as assigned (eg on call duties). . Participate in the clinic quality assurance, utilization review , risk management , and peer review activities. ... Contract HCW shall demonstrate skills in interviewing, examination, assessment, and management of patients with general medical and surgical health problems.… 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
- Office of the Secretary of Defense (Arlington, VA)
- …systems with program initiatives and utilizes advanced technology for effective data management , ensuring the department remains at the forefront of financial ... management practices. Provide expert advice, oversee budget policy, and...oversee budget policy, and recommend efficient and effective fund utilization strategies. Develop and managing long-term budget plans and… more
- Somatus (Mclean, VA)
- …+ Travel (up to 25%) to local renal care providers for quality oversight and utilization review collection + Other duties as assigned. _Please note this job ... and policies of Somatus + Assist Directors of Quality on quality and utilization audits as assigned, including targeted audits as requested by the Director. +… more
- CBRE Government and Defense Services (Reston, VA)
- …Summary** The Director of Operations will be responsible for providing regional management and oversight of aP&L of +$30M of design-build and design-bid-build ... government personnel. Negotiate contracts and bids with vendors and subcontractors. Review jobsite monthly reports and evaluate performance and compliance and lead… more
- AHU Technologies, Inc. (Washington, DC)
- …and Responsibilities The resource performs background investigations that includes the review of documents, and financial data to determine the applicants' ... activities. 6. Prepares clear and comprehensive investigative reports. 7. Performs effective utilization of the Microsoft Office Suite for tasks such as data entry… 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
- Red River (Chantilly, VA)
- …paced environment. + Email Administration with basic level of user management including configuring new accounts, password resets, and troubleshooting user login, ... direction on severity 1 tickets and calls, as well as overall SLA management while adding value and contributing to overall team performance.? + Maintain accuracy… 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
- 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
- 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
- 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
- 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
- Koniag Government Services (Germantown, MD)
- …weapons design, nuclear material production, counterintelligence, weapon science, and military utilization of nuclear weapons to review and assess documents. ... Services, LLC,** a Koniag Government Services company **,** is seeking a Document Reviewer Level 5 (DRL5) with Top- Secret clearance to support **KPS** and our… 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
- Koniag Government Services (Germantown, MD)
- …Professional Services** , a Koniag Government Services company, is seeking a Document Reviewer Level 1 (DRL1) with a Top-Secret clearance to support KPS and our ... Services, a Koniag Government Services company is seeking an entry-level Document Reviewer Level 1 (DRL1) to conduct classification reviews of government agency… more
- Koniag Government Services (Germantown, MD)
- …Professional Services** , a Koniag Government Services company, is seeking a Document Reviewer Level 3 (DRL3) with a Top-Secret clearance to support KPS and our ... Services, a Koniag Government Services company, is seeking an experienced Document Reviewer Level 3 (DRL3) to conduct classification reviews in accordance with… more
- Elevance Health (Washington, DC)
- …to clients/ members. The medical director provides clinical expertise in all aspects of utilization review and case management . Provides input on the ... means that the medical director is directly involved in Utilization Management and Case Management ....state or territory of the United States when conducting utilization review or an appeals consideration and… more
