- Datavant (Richmond, VA)
- …quality, compliance assessments, external payer reviews, coding education, interim coding management , and coding workflow operations reviews. In this role, you will ... Preferred: Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART software experience preferred. **You Will:** + Conduct inpatient… more
- US Tech Solutions (Chesapeake, VA)
- …+ Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and ... all levels to enable decision making at most appropriate level **Duties:** + Nurse Case Manager is...face and telephonically assessing, planning, implementing, and coordinating all case management activities with members to evaluate… more
- Veterans Affairs, Veterans Health Administration (Hampton, VA)
- …to Veterans and their care within the HBPC Program. Responsible for case management , assessment, triage, Veteran education, resource coordination, medication and ... in nursing who have completed coursework equivalent to a bachelor 's level degree in Nursing may have...(may be extended up to two years on a case -by- case -basis.) NOTE: Grandfathering Provision - All persons… more
- Navy Exchange Services (NEX) (Virginia Beach, VA)
- …Sec.1614 and applicable federal law. Provides supports in the creation of the Management Directive 715 MD715 report and the operations of Barrier Analysis Teams BATs ... bi-weekly SITSUM, etc. - Assist EEO Managers by maintaining case tracking for EEO Complaint and Reasonable Accommodation (RA)...1 year of academic study above the high school level may be substituted for 9 months of experience,… more
- Datavant (Richmond, VA)
- …The specialist serves as a key liaison between coding, billing, utilization review, case management , and payer relations to reduce denials and improve revenue ... (EHR) systems. + Collaborate with internal departments (HIM, billing, case management , patient access) to investigate and...you will bring to the table:** + Associate's or Bachelor 's degree in Health Information Management , Health… more
- Sedgwick (Richmond, VA)
- …RN license in a state or territory of the United States required. Certification in case management required. Bachelor 's degree in nursing (BSN) from an ... ensure efficient, cost effective, and high quality delivery of case management and utilization review services to...of factors including but not limited to skill set, level of experience, and cost of specific location. For… more
- USAA (Chesapeake, VA)
- …compliance with state laws and regulations. Accountable for delivering a concierge level of best in class member service through setting appropriate expectations, ... understanding of the auto claims contract as well as application of case law and state laws and regulations. + Proficient negotiation, investigation, communication,… more
- General Motors (Richmond, VA)
- …issues such as discrimination, harassment, and benefits fraud. Oversees end-to-end case management , ensuring timely resolution and alignment across Legal, ... and other constituencies to ensure alignment and accountability across case management projects + Handle cases as...guidance to People HR regarding AIMS at a global level , managing global initiatives and change management … more
- Lumen (Richmond, VA)
- …discovery and requirements gathering, scoping and business impact analysis, business case development, resource modeling, technical design, service level ... solution objectives and success criteria, provide advisory support for business case development, manage the design and execution strategy, and build consensus… more
- United Therapeutics (Richmond, VA)
- …a SME on evaluating and ensuring appropriate quality standards and adherence to case processing procedures. You are passionate about PV and enjoy partnering with ... vendors and partners to ensure the highest level of quality and compliance with respect to ISCR...Lead Pharmacovigilance QC Specialist provides strategic oversight of end-to-end case safety quality, ensuring compliance, and quality in adverse… more