- Greenspring Village by Erickson Senior Living (Springfield, VA)
- …clinical leadership meetings such as Wound Rounds, Clinical Operations Meeting, Utilization Review , and Performance Improvement/Risk Management /Safety ... clinical practice and processes in accordance with the Erickson Senior Living Management Policies and Procedures and nursing standards of practice. Ownership of… 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
- Greenspring Village by Erickson Senior Living (Springfield, VA)
- …weight loss, and dehydration. Participating in Wound Rounds, Operations Meetings, Utilization Review , and Performance Improvement/Risk Management /Safety ... (PI/RM/S) Committee. Reviewing clinical outcomes to ensure that we stay above the National, State, and Erickson benchmarking thresholds. Collaborating with DON to plan, develop and maintain the clinical operational budget for the nursing department. Partnering… more
- Washington Metropolitan Area Transit Authority (New Carrollton, MD)
- …as required. + Provides expert advice, guidance, and consultation to WMATA's senior management on space utilization & allocation. + Develops and manages updates ... 8+ years of experience in interior architectural design, administrative office facilities management , and at least 5 years of experience in facilities occupancy… 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)
- …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
- 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
- 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
- Monte Nido (Clifton, VA)
- …may substitute leadership experience elsewhere. + Working knowledge of admissions and intake, Utilization Review , and 3rd party or insurance payers. + Previous ... + Knowledge of Diversity, Equity and Inclusion practices + Employee selection and performance management experience are a plus. + Must hold a Master's degree in a… 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
- Humana (Washington, DC)
- …**Preferred Qualifications:** + Experience in managed care pharmacy, particularly in utilization management review **Additional Information:** **Interview ... our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity… more
- Elevance Health (Ashburn, VA)
- …Alternate locations may be considered. The **Medical Director** will be responsible for utilization review case management for North Carolina Medicaid. May ... ** Utilization Management Medical Director- NC Medicaid**...state or territory of the United States when conducting utilization review or an appeals consideration 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
- Evolent (Washington, DC)
- …As a Clinical Reviewer , Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference ... Clinical reviewers are supported by Field Medical Directors (MDs) in the utilization management determination process. + Reviews charts and analyzes clinical… more
