- Elevance Health (Ashburn, VA)
- …work-life integration, and ensures essential face-to-face onboarding and skill development._ The ** Medical Management Clinician Sr** is responsible for ... types that require the training and skill of a registered nurse . Acts as a resource for...efficiency and effectiveness of the utilization reviews within the medical management processes. + Assesses and applies… more
- Elevance Health (Vienna, VA)
- …is granted as required by law._ The **LTSS Service Coordinator RN Clinician ** is responsible for overall management of member's case within the scope ... of licensure; provides supervision and direction to non- RN clinicians participating in the member's case in accordance with applicable state law and contract;… more
- Cecelia Health (Bethesda, MD)
- …We connect patients living with one or more chronic conditions to an expert clinician who helps them navigate day-to-day health management . Why Join Cecelia ... is Cecelia Health? Cecelia Health is a virtual specialty medical practice dedicated to improving cardiometabolic health outcomes across...work of at least 20 hours per week. + Clinician -centered philosophy: You are at the core of what… more
- Elevance Health (Ashburn, VA)
- **LTSS Service Coordinator - Clinician ** **Location:** The location for this position is Winchester, Springfield, Alexandria, Fairfax, Front Royal, Annandale, ... an accommodation is granted as required by law._ The **LTSS Service Coordinator- Clinician ** is responsible for working under the direction/supervision of an RN… more
- Highmark Health (Washington, DC)
- …+ 1-3 years of experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder or related ... and retrospective claims review basis. Review process includes a review of medical documentation, itemized bills, and claims data to assure appropriate level of… more
- Oracle (Washington, DC)
- …. **Requirements:** + **Licensed clinician (Physician, Advanced Practice Provider, Registered Nurse )** + Extensive knowledge across multiple Oracle Health ... and AI capabilities. Facilitate Value Measurement and outcomes across the clinician experience and quality metrics for targeted customer initiatives and… more
- Datavant (Washington, DC)
- …job function as delegated by management Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well versed in DRG downgrade denials and ... expertise successfully. Ideal candidate should be a Licensed Practical Nurse or Registered Nurse well...Word, Excel, Outlook, experience working in a health plan medical management documentation system a plus. Minimum… more
- Immigration and Customs Enforcement (Washington, DC)
- …(up to 30%). Education REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES: Must be a Registered Nurse , Nurse Practitioner/Physician Assistant, or in a Healthcare ... Phone use for extended periods of time. If licensed clinician or administration specialist, will be tasked to TDY...of the Deputy Assistant Director of Health Care Compliance, Medical Quality Management (MQM) Unit. The incumbent… more
- Oracle (Washington, DC)
- **Job Description** Oracle Health is standing up a specialized clinical product management team focused on medical device-aligned products. This team bridges ... awareness and readiness across the broader product organization. Qualifications Required: . Licensed clinician ( RN , PharmD, MD, NP, PA, or equivalent) with 5+… more
- Oracle (Washington, DC)
- **Job Description** Oracle Health is standing up a specialized clinical product management team focused on medical device-aligned products. This team bridges ... awareness and readiness across the broader product organization. Qualifications Required: . Licensed clinician ( RN , PharmD, MD, NP, PA, or equivalent) with 5+… more
- Humana (Washington, DC)
- …and drive execution without day-to-day oversight **Preferred Qualifications** + Background as a clinician ( RN , NP, PA, MD, PharmD, or similar) + Experience with ... to execution. The Lead Product & Strategy Manager - Provider Practice Management role is a critical member of the multidisciplinary clinical initiatives team… more