- Sedgwick Government Solutions (Bethesda, MD)
- Job Details Medical Review Physician ( Remote /Onsite) 2024-1376 Bethesda, Maryland, United States Medical Services Full Time Description **Overview - ... Medical Review Physician ( Remote /Onsite)** **Salary Range: ($175k-$195k) depending on experience and qualifications.** Would you like to make the most of… more
- Veterans Affairs, Veterans Health Administration (Charlotte Hall, MD)
- …the computerized medical record system for progress notes, orders, prescriptions, and medical record review and completion of such records in a thorough and ... residents and fellows. Supervision of trainees is a component of the physician 's responsibility. Supervision includes review of pertinent history and examination… 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
- Veterans Affairs, Veterans Health Administration (Washington, DC)
- …studies performed on VA patients at the sleep lab at the Washington DC VA Medical Center. This is largely a daytime position with staging & scoring of sleep studies ... BiPAP or variants. The incumbent assists in the education of students ( medical students, polysomnography students) and residents and fellows. Based on experience and… 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)
- …including the insurance payers, specialty pharmacies, support organizations, and the patient/ physician to facilitate coverage and dispense of product in a timely ... * Knowledge of DME, MAC practices, preferred * Clear understanding of Medical , Supplemental, and pharmacy insurance benefit practices, preferred * 1-2 years of… more
- Merck (Washington, DC)
- …customers may include:** + Health care providers such as physicians, physician assistants, nurse practitioners, nurses, pharmacists as well as quality directors ... at product workshops and conferences, as well as consistent and ongoing review of Company promotional materials. + Providing Company management with updates on… more
- Humana (Washington, DC)
- …change management and measurement, and/or process-driven systems requirements. + Review of internal quality metrics. + Support process improvement initiatives: ... new Job Aids to support Training & Operations. + Review current Job Aids and Policies and Procedures as...quality or process improvement experience in a hospital or physician office practice. + Strong business skills, including sales… 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
- Evolent (Washington, DC)
- …at Evolent will serve as a point of contact for processing medical treatment requests in accordance with departmental policies, regulatory requirements, and client ... clinical team, which includes our Nurse, Clinical Reviewers and Field Medical Directors. Opportunities to work collaboratively with other Clinical Operation Leaders… 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, 10:00am- 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
- Evolent (Washington, DC)
- …operations this individual also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: ... to determine if submitted requests require a prior authorization review or redirect as required. + Entering data into...into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be… more