- Office of the Secretary of the Interior (Arlington, VA)
- …preference does not apply to the Senior Executive Service (SES). Responsibilities The Director Office of Hearings and Appeals is located in the Office ... exercises program management and administrative responsibilities with respect to the hearings and appeals functions of the Department in accordance with… more
- Humana (Washington, DC)
- … Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Prime Therapeutics (Washington, DC)
- …request by phone or fax. + Provides clinical rationale for standard and expedited appeals . + Provides assistance and act as a resource to Initial Clinical Reviewers ... guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a...On a requested basis, reviews appeal cases and/or attends hearings for discussion of utilization management decisions. + On… more