- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …This includes preparation of image data set and initial measurements for physician review . Coordinate care and prepare patients for transesophageal ... other health services we offer at Washington DC VA Medical Center. Responsibilities This Physician Assistant will...of the PA patient care audit processes involving in-depth review and analysis of medical records. Preferred… more
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …information, and the other health services we offer at Washington DC VA Medical Center. Responsibilities The physician shall provide primary care services ... required for VA beneficiaries. The physician shall provide care at the Washington DC VA Medical Center or at the associated Community Based Out Patient clinics… more
- Highmark Health (Washington, DC)
- …URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review , the incumbent participates as the physician member of the multidisciplinary ... and improve the care of our members **ESSENTIAL RESPONSIBILITIES** + Conduct electronic review of escalated cases against medical policy criteria, which may… more
- Amgen (Washington, DC)
- …that can turn the tide of serious, life-interrupting illnesses. **Clinical Research Medical Director, Endocrinology/Sleep Apnea** **What you will do** Let's do this. ... change the world. The Obesity organization is seeking a Medical Director that will work with a team of... Director that will work with a team of physician -scientists that support evidence generation for obesity and obesity-related… more
- Humana (Washington, DC)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities,… more
- Humana (Washington, DC)
- …direction and receives guidance where needed. Follows established guidelines/procedures. + Review medical documentation for clinical indicators to ensure ... caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted...Perform CPT Procedure reviews + Maintain strict patient and physician confidentiality and follow all federal, state and hospital… more
- Evolent (Washington, DC)
- …and guilds, and across health plan partners. **Qualifications for the Role** + MD/DO/MBBA Physician + Active/Unrestricted Medical License in one or more states + ... to achieve better outcomes for people with complex health conditions. Working across medical specialties and primary care, we seek to ensure that care plans align… more
- Erickson Living (Silver Spring, MD)
- …for alternative medical care for approval by the primary care physician . + Assists health plan members and their families in selecting care options ... Village by Erickson Senior Living **This is NOT a remote or hybrid opportunity** **_The Centers for Medicare and... medical practice; insurance benefit structures and related legal/ medical issues; and utilization review and quality… more
- Cardinal Health (Washington, DC)
- …for driving complex, consultative sales of Navista memberships to new physician practice customers through face-to-face or telephone contact to meet individual ... customers at all levels, leads the acquisition of new physician practices, and focuses on winning to meet development...on winning to meet development objectives. This is a remote , work from home position with travel. This position… more
- Cardinal Health (Washington, DC)
- …+ Manage workload of inbound faxes (if applicable) + Investigate and resolve patient/ physician inquiries and concerns in a timely manner + Enter detailed information ... team members regarding next steps + Communicate with external constituents including physician offices and pharmacies + Ability to identify, document and submit… more
- Lincoln Financial Group (Washington, DC)
- …Charlotte, NC (North Carolina); Omaha, NE (Nebraska); Work from Home **Work Arrangement:** Remote : Work at home employee residing outside of a commutable distance ... organization. This position will be responsible for reviewing, analyzing, and interpreting medical information available for disability claims. In this role you will… more
- Guardian Life (Washington, DC)
- …experience. **Activity** Review and assess claimant subjective reports and objective medical evidence to determine the impact of medical conditions on ... assessments. Specifically define issues to be addressed or clarified by outside physician or provider and oversee quality of review . Follow best practices… more
- Cardinal Health (Washington, DC)
- …Law, HIPAA and other laws applicable to management services organization and physician practices + Demonstrate strong business acumen and draft and negotiate ... + Strong preference for candidates with prior experience handling physician employment agreements, management service agreements, vendor contracts (eg revenue… more
- Highmark Health (Washington, DC)
- …including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and ... identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS… more
- Humana (Washington, DC)
- …outreaches to ensure that Humana members view the most accurate data when searching Physician Finder Plus. If you enjoy working to ensure our members have a positive ... experience when utilizing Physician Finder Plus, come join Humana's DDG team. **Typical...ramp-up period so they can develop their skills **Location:** Remote **Virtual Pre-Screen** As part of our hiring process… more
- Cardinal Health (Washington, DC)
- …including the insurance payers, specialty pharmacies, support organizations, and the patient/ physician to facilitate coverage and delivery of product in a timely ... and the Affordable Care Act preferred + Knowledge of Medical /Pharmacy billing and coding is preferred + Important to...flexibility to work a scheduled shift of 7am-7pm CT.** ** REMOTE DETAILS: All US residents are eligible to apply… more
- Cardinal Health (Washington, DC)
- …Networks works with over 10,000 providers across 1,500+ independent specialty physician practices and groups. The _Consultant, Customer Success_ individual will ... development of their assigned customer base. **Location** - Fully remote (expectation of less than 10% travel, which typically...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Cardinal Health (Washington, DC)
- …including the insurance payers, specialty pharmacies, support organizations, and the patient/ physician to facilitate coverage and dispense of product in a timely ... our normal business hours of Monday-Friday, 7:00am- 7:00pm CST. ** REMOTE DETAILS:** You will work remotely, full-time. It will...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Cardinal Health (Washington, DC)
- …application process for needy indigent or low-income persons. **This is a remote position supporting NYC Health + Hospital.** **Shift time is 8:00AM-5:00PM Eastern ... sales reps and pharmaceutical companies + Discuss medication options with physician and patient based on accessibility and availability (outpatient environment) +… more