- Elevance Health (Richmond, VA)
- **Appeals Medical Director - Medicare ** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May...York.** In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package,… more
- Humana (Richmond, VA)
- …our caring community and help us put health first** Senior Healthcare Network Consultant / Senior Network Performance Professional at Humana, you will play a pivotal ... through strategic initiatives and strong relationship-building. Senior Healthcare Network Consultant /Senior Network Performance Professional + **Provider Collaboration** :… more
- ChenMed (Richmond, VA)
- …and we need great people to join our team. The Membership Growth Consultant (MGC) is an outside healthcare sales representative who's responsible for generating ... talks, etc.) to help reach our ideal patients (ie, medically underserved, Medicare -eligible seniors, age 55 and older). + Cultivates strong relationships with health… more
- Oracle (Richmond, VA)
- …Applies Oracle methodology, company procedures, and leading practices. As a Lead Consultant you will consult on data and modelling impacts, guiding clients through ... visualization tool like BO or Tableau + Healthcare experience with Medicaid/ Medicare Claims Reporting **Expectations** + Perform other responsibilities as assigned +… more
- Baylor Scott & White Health (Richmond, VA)
- **Description - External** **JOB SUMMARY** The Healthcare Billing Compliance Consultant Sr performs ongoing activities related to the development, implementation, ... a timely way. . Responds to inquiries and guidance requests utilizing applicable Medicare and Medicaid rules and regulations. Serves as a compliance resource to BSWH… more
- Sedgwick (Richmond, VA)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Consultant (Examiner) | Public Entity | Remote **Are you looking for an ... principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. + Technically skilled… more
- CareFirst (Fairfax, VA)
- …aggressively pursues growth within groups by developing and implementing account specific benefit and financial strategies. + Manages and develops a set of assigned ... underwriting principles; group health/life insurance financial/funding mechanisms; stop loss, medicare advantage, wellness, clinical, managed care and point solutions,… more
- Humana (Richmond, VA)
- …with the organization's strategy and long-term goals. * Serve as a consultant to application teams, guiding them in creating enterprise-grade applications that ... leadership and consulting. + Knowledge of healthcare business domains, including Medicare , Medicaid, Group, Specialty, etc. + Development level knowledge utilizing… more
- University of Virginia (Charlottesville, VA)
- …COPD, CHF, CKD, dementia, etc.), preventive health services, immunizations, Medicare wellness visits, and urgent same-day evaluation/treatment. + Prescribes and ... and access to community resources. + Serves as a clinical resource and consultant for primary care, geriatrics, and urgent care topics to colleagues, nursing staff,… more
- ChenMed (Richmond, VA)
- …mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...work to develop and improve leadership skills for the benefit of one's patients, their team, their center and… more