- 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 (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
- Somatus (Mclean, VA)
- …Integrity Product Areas:** Clinical Claim Review , Payment Analytics, Fraud Capture, Utilization Review **Product Management ** + **Build** business cases ... our mission. Responsibilities **The Impact** **You'll** **Make:** + **Lead** performance management tied to key metrics and business drivers that inform strategic… more
- Foxhole Technology (Washington, DC)
- Overview Position: Software Product Management Lead Location: Washington DC (Hybrid) Clearance: Secret Start: Based on contract award Foxhole Technology provides ... . Foxhole Technology is seeking an experienced Subject Matter Expert Software Production Management Lead as part of a team of information assurance professionals in… 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
- Battelle Memorial Institute (Arlington, VA)
- …understanding of capture processes to win new business including: the gate review process; developing a capture strategy; planning capture milestones, managing a ... and delivery of compliant, responsive, innovative and integrated technical solutions and management approaches that are competitive and cost effective. + Passion and… 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
- American Bankers Association (Washington, DC)
- …national significance equals a winning combination! Click Here to review ABA's holistic approach to Benefits and Total Rewards. ... the Chief Finance & Administration Officer (CFAO), shaping financial strategy, risk management , and investment decisions while leading a team of eleven responsible… 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
- 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 (Crystal City, VA)
- …Gate Reviews are milestones of maturity for business development opportunities. Gate Review Calendar coordination and management requires clear organization of ... to be there. Also includes responsibility for SharePoint administration of Gate Review request portal; logging Gate Review participants; advancing approved… 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
- AmeriHealth Caritas (Washington, DC)
- …meet the patient's needs in the least restrictive and most effective manner. The Utilization Management Reviewer must maintain a strong working knowledge of ... **$5,000.00 SIGN ON BONUS** **Role Overview** Our Utilization Management Reviewers evaluate medical necessity...cases are escalated to the Medical Director for further review . The reviewer independently applies medical 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
- 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
- Humana (Washington, DC)
- …. + Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial ... their daily work. The Medical Director's work includes computer-based review of moderately complex to complex clinical scenarios, ...with prior experience participating in teams focusing on quality management , utilization management , case … more
- Evolent (Washington, DC)
- …cost-effective care. **Collaboration Opportunities** : As a Radiation Technologist in the Utilization Management department, you will work closely with other ... per guidelines. + Utilizing clinical guidelines approved by the Utilization Management Committee (UMC), the URN has...medical necessity, the request is sent to a physician reviewer . At no time can a URN recommend an… more
- Elevance Health (Washington, DC)
- …Prepares reports and documents all actions. + Responsibilities exclude conducting any utilization management review activities which require interpretation ... determines appropriate area to refer or assign case ( utilization management , case management , QI, Med Review ). + Provides information regarding network… 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
