- Evolent (Richmond, VA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Richmond, VA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... setting? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Richmond, VA)
- …and provides clinical rationale for standard and expedited appeals. . Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... the culture. **What You'll Be Doing:** As a Field Medical Director, Oncology, you will be a key member...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Richmond, VA)
- …+ Provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Richmond, VA)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...MD review process to reflect appropriate utilization and compliance with… more
- Evolent (Richmond, VA)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... Imaging cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests...MD review process to reflect appropriate utilization and compliance with… more
- Humana (Richmond, VA)
- …insurance, or other healthcare providers. + Utilization management experience in a medical management review organization, such as Medicare Advantage, Managed ... caring community and help us put health first The Medical Director actively uses their medical background,...first The Medical Director actively uses their medical background, experience, and judgement to make determinations whether… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …enhancement in a flexible interdisciplinary fashion. **Essential Functions:** + Review medical history, nursing intake and exercise history/ETT prior ... recognized for clinical and operational excellence. **_Exercise Specialist_** **_Maryview Medical Center in Portsmouth, Virginia_** **_PRN, as needed (Flexible… more
- Humana (Richmond, VA)
- …direction and receives guidance where needed. Follows established guidelines/procedures. + Review medical documentation for clinical indicators to ensure correct ... our caring community and help us put health first** The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure… more
- Bon Secours Mercy Health (Portsmouth, VA)
- …suspicion that the exam order is incorrect. + Utilizes the hospital electronic medical record to review patient information, enter preliminary reporting, and ... and minimize patient anxiety. + Contacts referring physician (or other appropriate medical personnel) for clarification prior to performing an exam if there is… more