- Immigration and Customs Enforcement (Washington, DC)
- …with the IHSC Medical Quality Management Unit. SUPERVISORY CONTROLS: The Clinical Senior Nurse Specialist, Medical Asset Support Team (MAST) ... national process changes identified by unit chart reviews, nursing incident reports, Medical Quality Management Unit (MQMU) review /reports, and any corrective… more
- Evolent (Washington, DC)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- Georgetown Univerisity (Washington, DC)
- …shared dedication to making a difference in the world. Requirements Job Overview Clinical Research Nurse , CTSA/ Clinical Research Unit - Georgetown University ... The Clinical Research Nurse (CRN) provides expert, independent care...to meet the evolving needs of the University. Such review may necessitate a change to a position's mode… more
- AmeriHealth Caritas (Washington, DC)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health ... patient needs. This role requires reviewing provider requests, gathering necessary medical documentation, and making determinations based on clinical criteria.… more
- Fresenius Medical Center (Washington, DC)
- **About this role:** As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining clinical ... kidney disease. **Training and advancement:** You will enter our Clinical Leadership Program that creates and supports a culture...a tremendous asset that sets us apart. At Fresenius Medical Care, you will truly make a difference in… more
- Cognizant (Washington, DC)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. + Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. + Medical Necessity Reviews can… more
- Elevance Health (Washington, DC)
- ** Clinical Fraud Investigator II - Registered Nurse and CPC - Calrelon Payment Integrity SIU** **Location:** This role enables associates to work virtually ... Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical -expense spending. The ** Clinical Fraud Investigator II** is responsible… more
- Fresenius Medical Center (Washington, DC)
- …regulations at: https://content.intranet.fmcna.com/regulatory-affairs/wp-content/uploads/sites/46/2019/05/Pre-Licensed- Nurse -50-State- Review ... of the hemodialysis health care team as a Registered Nurse Applicant, under the direction or supervision of a...transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab… more
- Gentiva (Fairfax, VA)
- …(LCD) criteria per hospice policy and regulatory requirements. + Communicate clinical findings, review treatment plans, lab results, diagnostics, and ... Partnerships. Transform Hospice Care.** We are seeking a dedicated Hospice Nurse Practitioner to perform Face-to-Face (F2F) encounters essential for hospice… more
- Fresenius Medical Center (Fairfax, VA)
- …Functions as part of the hemodialysis health care team as a Staff Registered Nurse to ensure provision of quality patient care on a daily basis in accordance ... + Reviews, transcribes, and enters physician lab orders accurately into the Medical Information System. + Ensures appropriate preparation of lab requisitions for… more
- Battelle Memorial Institute (Arlington, VA)
- …Research and Analytics (HRA) business line is seeking a highly motivated, full-time ** Nurse Case Manager** to join our team in support of our government customer, ... and their families, ensuring comprehensive support for those who serve. As a Nurse Case Manager, you will contribute to impactful research and analytics that drive… more
- Sunrise Senior Living (Alexandria, VA)
- …is to be a part of.** **Job ID** 2025-236117 **JOB OVERVIEW** The Wellness Nurse is responsible for monitoring the health and well-being of our residents and ... administration, communication with resident support services and families, and maintaining clinical quality assurance while leading and demonstrating the Mission for… more
- Cayuse Holdings (Washington, DC)
- … Director with monitoring Local, State, and/or Federal mailboxes and inform the Medical Director of all urgent matters. + Review and interpret spirometry ... **Overview** **The Work:** The Registered Nurse provides occupational health services to support the...ensuring employee well-being, and upholding the highest standards of medical care. Our client provides a wide range of… more
- Ageless Mens Health (Fairfax, VA)
- …Ageless Men's Health is seeking an experienced and compassionate Physician Assistant (PA-C) or Nurse Practitioner (NP) to join our clinical team in our Fairfax ... Physician Assistant (PA-C) or Nurse Practitioner (NP) - Men's Health Clinic |...modifications to enhance results. + Collaborating closely with the medical director and clinical leadership to maintain… more
- HCA Healthcare (Falls Church, VA)
- …Mental Health Nurse - RN opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. **Unlock the ... positions. Join our Team as a(an) Children's Mental Health Nurse - RN and access programs to assist with...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Erickson Living (Springfield, VA)
- …(LPN)/Licensed Vocational Nurse (LVN). The LPN/LVN is responsible for providing clinical care to residents in the neighborhood according to the nursing standards ... clinical condition, document findings in the resident electronic medical record, and notify the provider and/or RN when...a timely and professional manner + Participating in the review of clinical indicator reviews - falls,… more
- CenterWell (Washington, DC)
- …complaints. + Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to ... to work every other holiday.** The **Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for...Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services +… more
- Cayuse Holdings (Washington, DC)
- … Director with monitoring Local, State, and/or Federal mailboxes and inform the Medical Director of all urgent matters. + Review and interpret spirometry ... **Overview** The Registered Nurse provides occupational health services to support the...ensuring employee well-being, and upholding the highest standards of medical care. Provides a wide range of services, including… more
- BioLife Plasma Services (Forestville, MD)
- …You will report to the Plasma Center Manager and will perform as a Medical Support Specialist (Plasma Center Nurse ) to support plasma center operations. BioLife ... of laboratory test results, and donor notification of unsuitable test results. The Medical Support Specialist (Plasma Center Nurse ) works under the guidance of… more
- CVS Health (Springfield, VA)
- …of network management and clinical coverage policies. Through the use of clinical tools and information/data review , conducts an evaluation of member's needs ... all case management activities with members to evaluate the medical needs of the member to facilitate the member's...current unrestricted Virginia state licensure required - 3+ years clinical experience as a Registered Nurse (ie… more