- CVS Health (Washington, DC)
- …role are related to Medicare Appeals . * Direct daily work on part C appeals (both provider and member /nonparticipating providers) and Part D appeals . * ... after hours and weekend coverage on a rotational basis to support 24/7 appeals work * IRE monitoring and tracking and Utilization Management Strategy support *… more
- Humana (Washington, DC)
- …Director relies on medical background and reviews health claims and preservice appeals . The Corporate Medical Director reviews cases of diverse scope and complexity ... required, for various states in region of assignment + Board Certified in an approved ABMS Medical Specialty +...from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information This is a remote… more
- Office of Personnel Management (Washington, DC)
- …administrative litigation in fora including the General Accountability Office and Civilian Board of Contract Appeals . Providing legal advice and assistance to ... Summary The Office of Personnel Management (OPM) seeks an experienced litigator familiar...exempt from the competitive service. Must be an active member in good standing of the Bar of a… more
- Environmental Protection Agency (Washington, DC)
- Summary This position is in Office of Mission Support (OMS); Environmental Appeals Board (EAB). About the Office of Mission Support | US EPA. This is an ... connection with cases under administrative appeal to the Environmental Appeals Board . Assist one or more Senior...investigation is already on record with the Office of Personnel Management, you must undergo a background investigation. All… more
- Veterans Affairs, Veterans Health Administration (District Of Columbia, DC)
- …serves as a Staff Psychologist assigned to the VHA Central Office (VHACO) CSP Office as a member of the Review and Appeals (R&A) Team. As a member of the ... Summary The incumbent serves as a core member of the National Caregiver Support Program (CSP)...the tracking, monitoring, development, and submission of review and appeals through the application of regulation, policy, guidelines, and… more
- US Coast Guard (Alexandria, VA)
- …with other government agencies, and in litigation before the Comptroller General, the Civilian Board of Contract Appeals , Contract Adjustment Board , and the ... needed participates in representing the Government in protests, contract appeals cases presented by contractors under the "Disputes" clause...contracts. Being a CG civilian makes you a valuable member of the CG team. Typical work assignments at… more
- Federal Deposit Insurance Corporation (Washington, DC)
- …matters affecting FDIC-supervised institutions and their customers. Serves as a non-voting member of the Supervision Appeals Review Committee (SARC), advocating ... for the resolution of complex or sensitive inquiries, complaints, and appeals relating to FDIC regulatory and financial institution supervision, examination, and… more
- Immigration and Customs Enforcement (Washington, DC)
- …Convention Against Torture), OPLA's appellate advocacy and motions practice before the Board of Immigration Appeals , the interplay between removal proceedings ... OPLA provides legal advice and prudential counsel to ICE personnel on their law enforcement authorities, legal liability under..., the Equal Employment Opportunity Commission, and the Civilian Board of Contract Appeals . OPLA attorneys support… more
- Defense Logistics Agency (Fort Belvoir, VA)
- …of Federal Claims and appeals to the Federal courts and Armed Services Board of Contract Appeals (ASBCA). These contracts cover the acquisition of $12B of ... JD); 2) Proof that you are licensed and a member in good standing with the bar of the...responsibilities of the position. In accordance with DoDI 1442.2 ( Personnel Actions Involving Civilian Attorneys), promotion for this position… more
- Offices, Boards and Divisions (Falls Church, VA)
- …sets policies and goals for the Executive Office for Immigration Review, including the Board of Immigration Appeals and the Office of the Chief Immigration ... the heads of the EOIR components and all agency personnel in the execution of their duties. The direction,...to the Associate Attorney General with respect to the Board and Immigration Judge matters, including the processing of… more
- Humana (Washington, DC)
- …include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The ... type population (disabled or >65 years of age). + Board Certified in an approved ABMS Medical Specialty with...the care received by members in an assigned market, member population, or condition type. May also engage in… more
- Immigration and Customs Enforcement (Washington, DC)
- …Protection Board , the Equal Employment Opportunity Commission, and the Civilian Board of Contract Appeals . OPLA attorneys support DOJ in the prosecution ... complaints of prohibited discrimination, harassment, and retaliation/reprisal; and prohibited personnel practices and whistleblower retaliation; Serving as agency counsel… more
- Government Accountability Office (Washington, DC)
- Summary The Personnel Appeals Board 's General Counsel...after October 1, 1980. You must remain an active member in good standing of the bar in any United ... PAB/OGC attorneys conduct investigations regarding a wide range of personnel and labor matters and may represent GAO employees,...date of the announcement. You must be an active member in good standing of a bar of a… more
- Humana (Washington, DC)
- …include an overview of coding practices and clinical documentation, grievance and appeals processes, and outpatient services and equipment, within their scope. The ... or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A...the care received by members in an assigned market, member population, or condition type. May also engage in… more
- CVS Health (Washington, DC)
- …* Identify and address quality of care concerns with providers involved in a member 's care * Participate in the appeals process, including the investigation of ... and referral for care management * provide coverage for appeals as neede **Required Qualifications** * Board ...not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin,… more
- CVS Health (Washington, DC)
- …clinical / medical programs and expand Aetna's medical management programs to address member needs across the continuum of care. You will support the Medical ... Reviews / Peer to Peer Calls / First Level Appeals / Special Projects and Committee participation when needed....Carolina state medical license without encumbrances *M.D. or DO, Board Certification in an ABMS or AOA recognized specialty… more
- Humana (Washington, DC)
- …in an inpatient environment and/or related to acute inpatient rehabilitation + Board Certified in an approved ABMS Medical Specialty or AOA (American Osteopathic ... the care received by members in an assigned market, member population, or condition type. May also engage in...or condition type. May also engage in grievance and appeals reviews. Some medical directors may join a centralized… more
- Humana (Washington, DC)
- …type population (disabled or >65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current and unrestricted license ... the care received by members in an assigned market, member population, or condition type. May also engage in...or condition type. May also engage in grievance and appeals reviews. May participate on project teams or organizational… more