Healthcare Policy Analyst Jobs in Virginia

JOB SUMMARY The Business Intelligence Developer for Surgical Services will run queries in Clarity, support the CRD (Case Review Database), create automation in reporting through scripting, develop dashboards in Power BI ..

JOB SUMMARY The Clinical Informatics based Business Analyst has organization-wide responsibility for workflow processes impacted by Clinical Technology across disciplines/clinical departments. Will lead / participate in implementing large clinical process change. ..

JOB SUMMARY Oversees the delivery of patient care through subordinate staff and managers. Establishes operational goals, objectives and budgets for multiple complex departments. Responsibilities include establishment and implementation of optimal operating ..

... Bachelor's degree 4 years of healthcare experience Strong consultative and relationship ... Masters in Business, Finance or Healthcare Administration Six Sigma or PMP ... with the Tobacco Free Hiring..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..

Description The Associate Director, Problem, Incident and Event Management drives technical support teams to recover services during periods of service disruption or outages to key technology platforms/applications. The Associate Director, Problem, ..

Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..

Description Humana Special Needs Plans provide personalized guidance and resources to help members get the right care and information based on their specific condition or needs. Beneficiaries qualify with the following ..

Description Responsibilities The Compliance Professional 2 has responsibilities for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism Care Demonstration ..

... acumen to solve for the healthcare challenges of today. The Clinical ... years or more working in healthcare or a related industry 3 ... in business or public health..

Description The Senior Clinical Strategy and Practice Professional builds strategies for development, engagement, best clinical practices and processes for clinical community within the enterprise The Senior Clinical Strategy and Practice Professional ..

... Review ABA treatment plans for policy compliance. Assist with analysis of ... States with a focus upon policy and utilization management Participate in ... with Clinical Department and Program..

... etc. Requires understanding of Tricare policy on Autism Care Demonstration. Decisions ... are focused on ACD department policy and methods for completing assignments. ... Processing) . Two years prior..

Description The Pharmacy Clinical Advisor Professional 2 is an integral part of the Pharmacy Stars team which is accountable for Humana's Patient Safety and medication related Star measure performance. The Pharmacy ..

Description The Senior Policy Governance Professional policy Governance is the combination of ... toward achieving goals. The Senior Policy Governance Professional work assignments involve ... variable factors. Responsibilities The Senior..

Job ID 21000GCYAvailable Openings 1Position Specific Information Full-time role RN license is required Training in dialysis is offered PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an ..

Description Responsibilities The Consumer Service Operations Professional 2 evaluates claims oversight performance metrics by interfacing with the sub-contractor to gather and track associated reporting. The Consumer Service Operations Professional 2 evaluates ..

u003cpu003eu003cstrongu003eRole Summary:u003c/strongu003eu003c/pu003enu003cpu003eResponsible for the performance, productivity and quality within the MVH business unit. Ensuring internal/external customer satisfaction and compliance with government contracts, laws and regulations. Oversees process improvement and implementation. Responsible ..

Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..

... completed as required by ACD policy; administer &/or collect outcome measures ... measures as defined by ACD policy, provide outcome measure data to ... behavioral health, and/or ASD; a..

Description The Pre-Authorization Nurse 2 reviews Genetic testing prior authorization requests for appropriate care and setting, following guidelines and policies, and approves services or forward requests to the appropriate stakeholder. The ..

Description The Senior Compliance Professional ensures compliance with governmental requirements. The Senior Compliance Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an ..

Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..