Medical Director for Medicare Claims Review
2 weeks ago
Livanta, the largest healthcare quality improvement organization in the United States, is seeking a Medical Director to lead our CMS Comprehensive Error Rate Testing (CERT) medical review team.
About LivantaWe have a unique understanding of beneficiaries and have developed programs that improve beneficiary outcomes, increase satisfaction, and drastically reduce readmission. Our technology-driven approach enables us to inspire a better healthcare system that connects beneficiaries, providers, and payers to improve health outcomes, increase efficiency, and manage costs.
Job SummaryThis is a full-time, remote position where you will perform Medicare claims review for payment accuracy determinations as a Lead Medical Review Specialist. You will lead a team of nurse reviewers in making payment accuracy determinations, providing leadership direction and guidance to medical review staff. The successful candidate will have a knowledge and understanding of ICD-10-CM, CPT-4, and HCPCS Level II coding principles.
Responsibilities- Second-level claim determinations
- Lead a team of nurse reviewers
- Provide leadership direction and guidance to medical review staff
- Registered Nurse with bachelor's degree, associate degree, or diploma in nursing
- At least three years clinical experience
- Current license in one or more state
- Experience supervising medical review teams to ensure quality and production standards
- Experience applying coverage determinations and relevant policy to Medicare claims as a medical review nurse
- No adverse actions pending or taken by any license board
This position offers a competitive salary range of $85,000 - $115,000 per year, depending on experience. Additionally, we offer telecommuting options and a collaborative work environment.
Career DevelopmentWe are committed to supporting your career growth and development. If you are a motivated and experienced professional looking for a new challenge, please apply today.
-
Industrial Operations Director
2 weeks ago
Ajaccio, Corse, United States System One Full timeJob DescriptionAs an Industrial Operations Director at System One, you will oversee construction engineering activities for industrial projects. Your primary focus will be on Water/Wastewater Treatment plants, as well as factories, production facilities, and data centers across various industries.Duties and Responsibilities:Ensure project goals are...
-
Utilization Review Specialist
2 weeks ago
Ajaccio, Corse, United States LifeBridge Health Full timeWe are seeking a skilled Utilization Review Specialist - Case Management RN to join our team at LifeBridge Health.About the RoleThis part-time, weekend position will require you to conduct concurrent and retrospective chart reviews for clinical, financial, and resource utilization information. You will provide intervention and coordination to decrease...
-
Industrial Site Director
2 weeks ago
Ajaccio, Corse, United States System One Full timeAt System One, we are seeking an experienced Industrial Site Director to oversee construction engineering activities for industrial projects.The ideal candidate will have a strong background in overseeing onsite construction, with a focus on Water/Wastewater Treatment plants, factories, production facilities, and data centers across various industries.This...
-
Development Director
2 weeks ago
Ajaccio, Corse, United States American Heart Association Full timeJob Summary:The American Heart Association is seeking a Senior Development Director to lead fundraising efforts in the Metro Baltimore area. This position reports to the VP of Development and requires a strong leader with excellent interpersonal, communication, negotiation, and social skills.About the Role:We are looking for a seasoned professional with a...
-
Quality Assurance Director for Federal Systems
2 weeks ago
Ajaccio, Corse, United States Maximus Full timeAt Maximus, we are seeking an experienced Quality Assurance Manager to play a crucial role in ensuring the delivery of high-quality technology solutions to our clients. This position requires a strong understanding of the technology landscape, excellent leadership skills, and a passion for delivering exceptional products.About the RoleThe successful...
-
Business Finance Manager
1 week ago
Ajaccio, Corse, United States Birchmere Group Full timeJob Title: Business Finance ManagerAbout the Role:As a Business Finance Manager at Birchmere Group, you will be responsible for executing the Program's Budget through the creation and maintenance of spend plans, requisitions, and their supporting documents. You will also coordinate financial data with appropriate Government officials and contribute to the...
-
Senior QA Manager
2 weeks ago
Ajaccio, Corse, United States General Dynamics Information Technology Full timeJob SummaryThis position is responsible for the Quality Assurance program and processes. As a Senior QA Manager, you will review and provide feedback to the Government on documents and deliverables ensuring quality assurance requirements adhere to commercial best practices and comply with applicable DoD/NSA standards.Perform data quality analysis of...
-
Senior Financial Analyst
1 week ago
Ajaccio, Corse, United States Birchmere Group Full timeAt Birchmere Group, we are seeking a highly skilled Senior Financial Analyst to join our team. This is a challenging and rewarding opportunity for an individual who is passionate about finance and wants to make a real impact in the industry.Job DescriptionThe Senior Financial Analyst will be responsible for assisting in the execution of the Program's Budget...
-
Senior Acute Care Nurse Specialist
2 weeks ago
Ajaccio, Corse, United States LifeBridge Health Full timeWe are seeking a compassionate and skilled Licensed Practical Nurse (LPN) to join our team at Levindale Hebrew Geriatric Center and Hospital. As a key member of our Brain Health Unit, you will play a vital role in providing exceptional patient care and support to our residents.Job Summary:Under the supervision of the Registered Nurse/Director of Nursing, the...
-
Cyber Security Intelligence Specialist
2 weeks ago
Ajaccio, Corse, United States SOS International LLC Full timeAbout SOS International LLCSOS International LLC is a leading provider of intelligence solutions to government agencies and private organizations. Our team of experts has extensive experience in processing electronic signals, strategic C4I systems, and subsurface warfare signals identification and processing.Job OverviewWe are currently seeking a highly...
-
Ajaccio, Corse, United States Vibrint Full timeVibrint is a trusted provider of mission-critical systems and analysis that drive innovation and efficiency in data harvesting and utilization. As a System Engineer III, you will work alongside talented professionals to create and sustain solutions that meet the demands of various customer missions.Our team knows they're working on impactful projects at the...
-
Highly Skilled Systems Architect
1 week ago
Ajaccio, Corse, United States SITEC Consulting Full timeAbout SITEC ConsultingSITEC Consulting is a dynamic Information Technology and Professional Services Firm that specializes in designing, developing, and delivering cutting-edge technology solutions. Our team provides comprehensive services for software support activity software production facilities, including lifecycle management for our customers'...
-
Mission-Critical Systems Expert
1 week ago
Ajaccio, Corse, United States Artera Technologies Full timeAt Artera Technologies, we deliver innovative solutions to the Intelligence Community (IC) with a strong focus on systems engineering and software development.We are seeking a highly skilled Mission-Critical Systems Expert to join our team of experts. As a key member of our team, you will be responsible for providing technical direction for the development,...
-
Leading Systems Engineer for RF Innovation
1 week ago
Ajaccio, Corse, United States Lufburrow & Co Full timeLufburrow & Co is seeking a seasoned Senior Systems Engineer to spearhead the development of our cutting-edge RF Collection experience.Job OverviewThis position requires a highly skilled professional with extensive experience in System Engineering, RF and Software Designed Radios, and Management. The ideal candidate will be responsible for designing,...
-
Senior Language Intelligence Specialist
2 weeks ago
Ajaccio, Corse, United States IntelliGenesis Full timeAbout the Role">This exciting opportunity is for a highly skilled Senior Language Intelligence Specialist to join IntelliGenesis, a leading provider of advanced technology and engineering solutions. As a key member of our team, you will play a crucial role in supporting SIGINT operations by processing voice and graphic language materials.">Key...
-
Ajaccio, Corse, United States Amentum Full timeAmentum is seeking a highly skilled Software Engineer to join our team of passionate individuals working on challenging, mission-critical projects that make a direct impact on the nation's security and intelligence mission.About UsWe are a leading provider of professional services in the national security and government markets. Our expertise spans a range...
-
IT Solutions Engineer
2 weeks ago
Ajaccio, Corse, United States SITEC Consulting Full timeAbout SITEC ConsultingWe offer a competitive $120,000 - $180,000 per year salary for this position.Job OverviewSITEC Consulting is an IT and Professional Services Firm that specializes in design, development, and delivery of state-of-the-art technology solutions. Our team provides support services as required for continuous operation of our Software...
-
AP Associate: Timely Payables Specialist
2 weeks ago
Ajaccio, Corse, United States Aston Carter Full timeLooking for a detail-oriented and organized professional to join our team as an AP Associate. This role plays a vital part in ensuring the timely and accurate processing of payables and compliance.The ideal candidate will have excellent analytical skills, be able to work independently, and provide exceptional support to our accounting staff.About Aston...
-
Software Development Specialist
2 weeks ago
Ajaccio, Corse, United States Parsons Company Full timeAbout the RolePursue a career with endless opportunities at Parsons.We're currently seeking a Software Development Specialist who can thrive in a dynamic environment.As a Software Development Specialist, you will be the driving force behind our cloud-based solutions.The team delivers various capabilities, including data management, data delivery, high ingest...
-
Enterprise Vulnerability Specialist
2 weeks ago
Ajaccio, Corse, United States General Dynamics Information Technology Full timeJob SummaryWe are seeking a skilled Enterprise Vulnerability Specialist to join our team at General Dynamics Information Technology. This role involves maintaining and optimizing the Tenable Security Center infrastructure, conducting regular security patching, assessments, and scans on Linux Security Center servers using Tenable Nessus, and mitigating...