5,897 Clinical Reviewer Jobs in Washington, DC

Clinical Care Reviewer Utilization Management

AmeriHealth Caritas Health Plan Washington, DC

• Full-Time

The Clinical Care Reviewer will be scheduled to CORE or FLEX hours to provide access to medical necessity determinations for urgent and contractually required coverage requests on a 24/7, 365 basis

Clinical Reviewer

BRILLIENT CORPORATION Silver Spring, MD

Evaluate and review published literature to determine whether study designs and results meet the ... At least 1 year clinical oncology experience Preferred but not required: 1 year Prior regulatory ...

LPN Referral Management Reviewer

iCallidus Bethesda, MD

• $28 to $32 Hourly
• Full-Time

Performs clinical review of referrals under the direction/guidance of the product line nurse(s), IRMAC Referral Management Leadership. * Reviews all referrals for administrative, clinical ...

Supervisor, Non-Clinical Review D.C.

Comagine Health Washington, DC

• Full-Time

Supervisor, Non-Clinical Review * Provides operational supervision of clinical staff who conduct utilization review and/or specialty reviews. * The non-clinical supervisor will guide, train intake ...

Clinical Reviewer Lead D.C.

Comagine Health Washington, DC

• Full-Time

Clinical Reviewer Lead DC * The Clinical Reviewer Lead is responsible for designing, implementing, and evaluating reviews by coordinating, delegating, and supporting the Clinical Review team. This ...

CLINICAL CARE REVIEWER UM

Korak Healthsource Group Washington, DC

• Full-Time

Additional Information All your information will be kept confidential according to EEO guidelines.

Clinical Intake Specialist (Part-Time)

Goodwin House Alexandria, VA

Quick Apply

• Part-Time

This clinical position will review referrals from various sources such as hospital portals, faxes, phone calls, and emails to determine home health eligibility. This position will coordinate with ...

RN or LPN Utilization Review

Summit BHC Seabrook, MD

• Full-Time

The Utilization Specialist is responsible for reviewing of assigned admissions, continued stays, utilization practices and discharge planning according to approved clinically valid criteria which ...

Clinical Pharmacist - Clinical Reviews/Injectables (REMOTE - US BASED)

CareerGig Staffing Arlington, VA

Quick Apply

Remote

• Contractor

Responsible for the clinical review and medical necessity determination for medical injectable prior authorizations requested for the outpatient setting. This is an exceptional opportunity to do ...

PHYSICAL EVALUATION BOARD LIAISON OFFICER ASSISTANT (PEBLO ASSISTANT)

Anthony & Associates, Inc. Bethesda, MD

Quick Apply

• Full-Time

Responsible for Initiating Medical Data Completion Objective (MDCO) of service member's administrative data and routing to the clinical reviewer. * Types and proofreads DA Form 3947 and/or NAVMED ...

Clinical Supervisor

Zion Restoration Counseling Services Fairfax, VA

Quick Apply

• $73K to $77K Annually
• Full-Time

Reviews and approves progress notes * Open to "co-facilitating" training as called upon by Clinical Director * Participates in the development and implementation of new clinical groups and initiates ...

Registered Nurse (Utilization Management)

LanceSoft Inc Herndon, VA

• $37 to $42 Hourly
• Full-Time

The Utilization Management Nurse Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Utilization Management Nurse ...

LPN - Utilization Review

Potomac Healthcare SolutionsPotomac Healthcare Solutions Fort Belvoir, VA

• Full-Time

Licensed Practical Nurse (LPN) - Utilization Reviewer Ft. Belvoir, VA Position Duties and ... Perform clinical reviews to assess medical necessity of broad range of inpatient and outpatient ...

Clinical Appeals Reviewer, Registered Nurse, REMOTE

AmeriHealth Caritas Health Plan Washington, DC

• Full-Time

The Clinical Appeals Reviewer reports to the Supervisor Appeals and Grievances and is responsible for processing appeals and grievances ensuring all milestones are within compliance. * Outreaches to ...

Office Manager - Clinical Manager

Quadrant, Inc. Fairfax, VA

• $18 to $25 Hourly
• Contractor

Office Manager - Clinical Manager Fairfax, Virginia MUST: Experienced Office Manager 4 plus years ... reviewing service delivery compared to schedule; reminding provider of service delays Comforts ...

Patient Benefits Representative II

The US Oncology Network Silver Spring, MD

• Full-Time

... Clinical Reviewer, insurance pre-authorization or referral approval codes prior to each treatment.- Review patient account balance and notify front desk of patients to meet with-Ensure that patient ...

Pharmacy Workflow Coordinator

AIS Healthcare Fairfax, VA

• Full-Time

This is a document review process, not a clinical review. * Works collaboratively with all members of the nursing team including the quality nurses, field nurses and directors to ensure patient care ...

Manager Utilization Review & Clinical Documentation Improvement

Children's National Hospital Washington, DC

• Full-Time

This position will manage activities and staff of the Utilization Review and Clinical Documentation Improvement departments. Supervise and evaluate the daily work of these teams in accordance with ...

PROGRAM INTEGRITY MEDICAL REVIEW MANAGER

Healthcare Management Solutions LLC Columbia, MD

Quick Apply

• Contractor

In addition, the Medical Review Manager shall have the primary responsibility for ensuring the ... A minimum of five (5) years of clinical experience in an acute care hospital, skilled nursing ...

Clinical Psychologist (ADULT)

Posterity Group, LLC Washington, DC

Quick Apply

• $108K to $116K Annually
• Vision Medical 401k Dental
• Full-Time

Adult Clinical Psychologist - Fort Belvoir, VA ($108,015.00 - $116,426.00/YR) RELOCATION ASSISTANCE ... Medical records will be subject to review by the Medical Care Evaluation Committee, Quality ...