• Clinical Review, Physical Therapy - Part

    Evolent (Richmond, VA)
    …make denial determinations as a specific case warrants. + Converses with medical office staff in order to obtain additional pertinent clinical history/information; ... NCQA and health plans required timeframes. + Documents all communication with medical office staff and/or treating provider. + Practices and maintains the principles… more
    Evolent (08/08/25)
    - Related Jobs
  • Medical Record Retrieval Representative

    Humana (Richmond, VA)
    …Adjustment Representative 2 will contact and schedule with provider offices to return medical records timely. This role includes remote access retrieval from ... **Become a part of our caring community and help us...groups as well as administrative retrieval tasks. Virginia The Medical Records Retrieval Specialist ensures accurate and properly supported… more
    Humana (08/08/25)
    - Related Jobs
  • Senior Inpatient Medical Coding Auditor…

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Senior Inpatient Medical Coding Professional extracts clinical information from a ... variety of medical records and assigns appropriate procedural terminology and ...**Use your skills to make an impact** **WORK STYLE:** Remote /work at home. While this is a remote more
    Humana (08/02/25)
    - Related Jobs
  • Medical Director- South Central

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and… more
    Humana (07/11/25)
    - Related Jobs
  • Medical Director - Medicare Grievances…

    Humana (Richmond, VA)
    …a remote position. **Scheduled weekly hours** **:** 40 hours (full- time ): four 10-hour workdays per week, either Friday-Monday or Thursday-Sunday schedule. ... **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health… more
    Humana (08/08/25)
    - Related Jobs
  • Medicare Grievances and Appeals Corporate…

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health claims ... and preservice appeals. The Corporate Medical Director works on problems of diverse scope and...protect member PHI / HIPAA information This is a remote position Travel: While this is a remote more
    Humana (06/18/25)
    - Related Jobs
  • Senior Counsel ( Medical Device)

    Fujifilm (Richmond, VA)
    …+ Medical , Dental, Vision + Life Insurance + 401k + Paid Time Off *\#LI- REMOTE **EEO Information** Fujifilm is committed to providing equal opportunities ... are hiring a Senior Counsel to be an integral part of the legal team providing support to the... of the legal team providing support to the Medical Device businesses of FUJIFILM Healthcare Americas Corporation and… more
    Fujifilm (08/08/25)
    - Related Jobs
  • Behavioral Health Medical Director…

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Behavioral Health Medical Director is responsible for behavioral health care strategy ... and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex...requires an in-depth evaluation of variable factors. **Become a part of our caring community and help us put… more
    Humana (08/09/25)
    - Related Jobs
  • Medical Director - Mid West Region

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement ... reference materials, internal teaching conferences, and other reference sources. Medical Directors will learn Medicare and Medicare Advantage requirements, and… more
    Humana (08/08/25)
    - Related Jobs
  • Medical Director - NorthEast Region

    Humana (Richmond, VA)
    **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... situations or data requires an in-depth evaluation of variable factors. The Medical Director provides medical interpretation and decisions about the… more
    Humana (07/25/25)
    - Related Jobs