- Evolent (Richmond, VA)
- …Stay for the culture. **What You'll Be Doing:** As an Occupational Therapist, Clinical Reviewer you will be a key member of the utilization management team. We can ... needed or required. Job Summary Functions in a clinical review capacity to evaluate all cases, which do not...an approval cannot be rendered to the Physician Clinical Reviewer . In States where allowed, will make denial determinations… more
- Evolent (Richmond, VA)
- …Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review rationales and determinations. ... the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior approvals. Tasks are… more
- Evolent (Richmond, VA)
- …improvement functions under the auspices of the office of the Chief Medical Officer. ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may ... patients as directed by the office of the Chief Medical Officer. + Responsible for clinical conversations with providers...to ensure client satisfaction. + Perform all peer clinical review activities while located in a state or territory… 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 ... **What You'll Be Doing:** Job Description **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful… 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 ... culture. **What You'll Be Doing:** As a Physician Clinical Reviewer , Interventional Pain Management, you will be a key...reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests… more
- Oracle (Richmond, VA)
- …Regulatory Scientist to provide deep regulatory and scientific leadership for AI-enabled medical device solutions. This role sits within HDI's Regulatory & ... Medical Device organization. You will serve as a senior...lived both sides of the process - as a reviewer and as a submitter - bringing real-world regulatory… more
- Army National Guard Units (Richmond, VA)
- …a board, action officer, or others and ensures that all levels of legal, medical , and administrative review have been completed. Summarizes salient facts and ... perform the below duties: (1) Serves as a final reviewer and/or processor of actions, which may include but...unfavorable career separation or loss of status. Performs final review on file prior to review and… 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 ... culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of...Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet… 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...Will Be Doing:** + Serve as the specialty match reviewer in Vascular cases, that do not initially meet… 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...Will Be Doing:** . Serve as the Physician match reviewer in Advanced Imaging cases, that do not initially… more