HireTalentClinical Reviewer HireTalentClinical ReviewerMcLean, VARemoteAssesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department. Position is Remote HOWEVER Candidates MUST Reside in California and they need to have an active California license as a LCSW OR LMFT OR LPCC OR Licensed Social Worker.
Maximus Federal & VESClinical Reviewer Psychiatry Maximus Federal & VESClinical Reviewer PsychiatryMcLean, VARemoteThe Social Security Administration (SSA), Office of Hearings Operations (OHO), is seeking Medical Experts (MEs) to provide professional medical opinion and testimony in administrative hearings before an Administrative Law Judge (ALJ). If you’re interested in applying your clinical expertise in a meaningful, flexible capacity supporting federal disability determinations, we encourage you to apply.
CVS Health CorpPrior Authorization Clinical Reviewer CVS Health CorpPrior Authorization Clinical ReviewerVA$26.01–$74.78 / yearApplication of critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and medical necessity criteria for appropriate utilization of services for members with disabilities and special healthcare needs. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Maximus Federal & VESInfectious Disease Reviewer Maximus Federal & VESInfectious Disease ReviewerMcLean, VARemote$150–$400Maximus Federal is seeking a Board-Certified Infectious Disease Physician to support the California Department of Managed Healthcare (DMHC) as an Independent Medical Reviewer. Your clinical expertise helps ensure fairness in healthcare decision making for California enrollees.
VCU Health - MCV PhysiciansClinical Radiation Therapy Physicist - Radiation Oncology (M89557) - Medical Physicist VCU Health - MCV PhysiciansClinical Radiation Therapy Physicist - Radiation Oncology (M89557) - Medical PhysicistRichmond, VAThe mission of the Medical Physics division is to provide exemplary radiation therapy to patients through high-quality clinical services and advanced technologies, investigation and implementation of improved treatment planning and delivery methods, research programs designed to improve the efficiency and efficacy of radiation therapy, and clinical trials to assess the clinical advantages of radiation therapy treatment modalities. This is a clinical medical physicist position based primarily at the Adult Outpatient Pavilion (https://www.vcuhealth.org/locations/adult-outpatient-pavilion/), which is the main facility of the Department of Radiation Oncology at Virginia Commonwealth University Medical Center.
Commonwealth of VirginiaClinical Investigator | Family Medicine | School of Medicine | (F75880) Commonwealth of VirginiaClinical Investigator | Family Medicine | School of Medicine | (F75880)Richmond, VAPreference will be given to candidates who can effectively engage with our current faculty in several research projects that are funded and underway, as well as those who can quickly understand and grasp the unique challenges of working with a Practiced-Based Research Network (PBRN). We seek an Open Rank, tenure-eligible faculty investigator with responsibility for the design, development, execution, and dissemination of research on primary care and social determinants of health through externally funded, competitive research grants and contracts.
Elevance Health IncNewTransplant Nurse II Elevance Health IncTransplant Nurse IIRichmond, VA$83,248–$104,060 / yearWithin the case management role will within the scope of licensure assess, develop, implement coordinate, monitor, and evaluate care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their specific health needs. Within the medical management role will collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources for more complex medical transplant issues.
Elevance Health IncNurse Care Manager I Elevance Health IncNurse Care Manager IRichmond, VARequires 3 years full-time equivalent of direct clinical care experience to the consumer, 5 years full-time equivalent of direct clinical care experience to the consumer preferred or any combination of education and experience, which would provide an equivalent background, Multi-state licensure is required if this individual is providing services in multiple states. How you will make an impact: Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions and extensions of stay, outpatient services, out of network services, and appropriateness of treatment setting and level of care.