ZipRecruiter

Log In

1

Contract Case Reviewer Jobs in Virginia (NOW HIRING)

Constellis

Case Reviewer

VA · On-site

Review case work and provide feedback regarding quality and completeness * Contact Field ... Provide daily support and assistance to PMs, managers/Investigative Supervisors and Contract ...

Constellis

Case Reviewer

VA · On-site +1

Review case work and provide feedback regarding quality and completeness * Contact Field ... Provide daily support and assistance to PMs, managers/Investigative Supervisors and Contract ...

Constellis

Case Reviewer - DHS

VA · On-site +1

Review case work and provide feedback regarding quality and completeness * Contact Field ... Provide daily support and assistance to PMs, managers/Investigative Supervisors and Contract ...

Constellis

Case Reviewer - DHS

VA · On-site

Review case work and provide feedback regarding quality and completeness * Contact Field ... Provide daily support and assistance to PMs, managers/Investigative Supervisors and Contract ...

LAUKOA

Registered Nurse Case Manager

Alexandria, VA · On-site

$82K - $97K/yr

  • Medical

  • Dental

  • Vision

  • Life

  • Retirement

  • PTO

As a RN Case Manager (also known as a Permanent Case Reviewer) [PCR], you will provide the services ... The PCR will work in conjunction with other healthcare providers, professionals, and non-contract ...

TEEMA Group

$90 - $100/hr

Reviewing patient history and updating medical records * Client education on nutrition, parasite ... Independent Relief Contract * Case type: Wellness only * Species: Small animal (canine and feline)

Acentra Health

Clinical Reviewer-SCA

Mclean, VA · On-site

  • Medical

  • Life

  • Retirement

  • PTO

Assures accuracy and timeliness of all applicable review type cases within contract requirements ... Some knowledge of Case Management, UR and/or Prior Authorization or related experience is preferred

Acentra Health

Clinical Reviewer (SCA-Remote)

Mclean, VA · On-site

  • Medical

  • Life

  • Retirement

  • PTO

Assures accuracy and timeliness of all applicable review type cases within contract requirements ... Some knowledge of Case Management, UR and/or Prior Authorization or related experience is preferred

Encompass Health

Case Manager

Bristol, VA · On-site

$19.50 - $25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health

Case Manager

Charlottesville, VA · On-site

$35/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health

Case Manager

Fredericksburg, VA · On-site

$19.75 - $25.25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health Corporation

Case Manager

Fredericksburg, VA · On-site

$19.75 - $25.50/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health Corporation

Case Manager

Charlottesville, VA · On-site

$35/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health

Case Manager

Charlottesville, VA

$35/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

Encompass Health

Case Manager

Fredericksburg, VA · On-site

$19.75 - $25.25/hr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Review/analyze case management reports, including Key Care Indicators, and plan appropriate actions. * Understand commercial contract levels, exclusions, payor requirements, and recertification needs.

next page

Showing results 1-20

All JobsContract Case Reviewer JobsContract Case Reviewer Jobs in Virginia

Contract Case Reviewer information

What are the most commonly searched types of Case Reviewer jobs in Virginia?

The most popular types of Case Reviewer jobs in Virginia are:

What are popular job titles related to Contract Case Reviewer jobs in Virginia?

For Contract Case Reviewer jobs in Virginia, the most frequently searched job titles are:

What job categories do people searching Contract Case Reviewer jobs in Virginia look for?

The top searched job categories for Contract Case Reviewer jobs in Virginia are:

Contract Case Reviewer jobs near you

Case Reviewer

Constellis

VA • On-site

Full-time

Re-posted 24 days ago

Constellis rating

7.2

Company rating: 7.2 out of 10

Based on 45 frontline employees who took The Breakroom Quiz

39th of 116 rated security

Job description

POSITION SUMMARY

The Case Manager scrutinizes reports of investigations submitted by the Field Investigators to ensure accuracy, completeness, and timely submission to customer.

HOURLY RATE

Actual compensation will be determined based on factors including relevant experience, education, and contract requirements.

RESPONSIBILITIES

  • Provide advice and guidance to investigators on investigative and formatting requirements.
  • Review case work and provide feedback regarding quality and completeness
  • Contact Field Investigators regarding cost and quality exceptions with their work.
  • Monitor pending cases to ensure compliance with delivery due dates and track submission of investigative leads. Prioritize cases where noteworthy or derogatory information is developed.
  • Monitor pending cases, review and revise reports of investigation. Check for quality and take necessary actions to complete case. Annotate Investigator Quality Performance remarks.
  • Schedule additional leads as discovered in investigation.
  • Assist CQC Manager process Customer complaints, assign Investigator to determine validity of complaint and prepare response for customers and Project Managers
  • Interview Sources as part of the QA process
  • Provide daily support and assistance to PMs, managers/Investigative Supervisors and Contract Investigators regarding quality issues
  • Prepare statistical reports for customer reporting/Project Managers
  • Other duties as assigned.
  • Business work hours are Monday-Friday from 8:00 am to 5:00 pm, however some extended hours may be required.

QUALIFICATIONS

  • Must be a U.S. Citizen and at least 18 years of age;
  • Bachelor's Degree from four-year college or university; minimum five (5) years experience in background investigations and knowledge of the background investigation process; or equivalent combination of education and experience.
  • High reasoning skills, including ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in oral, written, diagram, or schedule form.
  • Intermediate math skills, including ability to calculate figures and amounts
  • High language skills, including ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to present information in an effective manner to senior management.
  • High computer skills and ability to work in a MS Windows based operating environment, including proficiency with Microsoft Office (Word, Excel, PowerPoint), Internet and E-mail.
  • Must be U.S. citizen and able to successfully undergo background investigation to obtain U.S. Government security clearance.
  • Active or ability to obtain and maintain a federal security clearance as required by the contract.
  • May be required to lift and carry awkward items weighing up to 25 lbs. Requires intermittent standing, walking, sitting, squatting, stretching and bending throughout the workday.

BENEFITS

Constellis offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflect its commitment to creating a diverse and supportive workplace.

What Constellis employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Apply