Recent Searches

You haven't searched anything yet.

6 Jobs in tysons, va

SET JOB ALERT
Details...
Maximus Services, LLC
Tysons, VA | Full Time
$125k-153k (estimate)
7 Days Ago
The Mather, Tysons
Tysons, VA | Full Time
$31k-40k (estimate)
3 Days Ago
Judge Group
Tysons, VA | Full Time
$91k-117k (estimate)
2 Weeks Ago
SecTek
Tysons, VA | Full Time
$36k-46k (estimate)
3 Months Ago
Bridge Core (BCore)
Tysons, VA | Full Time
$86k-108k (estimate)
3 Months Ago
Adtalem Global Education
Tysons, VA | Part Time
$83k-152k (estimate)
2 Months Ago
Nurse - Consultant
$125k-153k (estimate)
Full Time 7 Days Ago
Save

Maximus Services, LLC is Hiring a Nurse - Consultant Near Tysons, VA

Description & Requirements

Maximus is looking to fill a Nurse Consultant position. This role includes reviewing medical records, resolving technical issues, assessing facts, and undertaking special projects such as legal and medical research, proposal drafting, and project liaison duties as directed by management.

Essential Duties and Responsibilities:
  • Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations.
  • Render determinations for cases assigned .
  • Resolve all other technical issues within reconsideration assigned.
  • Review cases or sites assigned to determine and summarize facts and assess any issues identified.
  • Perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
  • Perform other duties as assigned by management.
  • Review cases to identify and summarize key facts of each case and assess issues involved in the appeal;
  • Research issues using current peer-reviewed medical literature, clinical guidelines, applicable state laws and regulations, and other sources as defined by the client contract;
  • Determine the adequacy of medical records and request relevant medical records as needed;
  • Review expert review findings and prepare determination letters;
  • Communicate the determination in a succinct written format;
  • Exercise independent judgment to ensure determination is accurate, well-supported, and defensible;
  • Perform other special projects not related to a specific case, such as general medical or legal research, drafting proposal sections, or acting as a liaison for a specific project, when needed;
  • Provide and holiday coverage on scheduled rotation; and
  • Perform other duties as assigned by management.
- Bachelor's degree with 3 - 5 years of experience OR Associate's degree with 5 - 7 years of experience; experience in health care appeals or health care claims, preferred;
  • Ability to successfully execute many complex tasks simultaneously and prioritize tasks according to urgency;
  • Ability to respond to the needs of outside contacts;
  • Working knowledge and use of PC, MS Word and Excel software;
  • Ability to work as a part of a team as well as independently, and promote positive company relations;
  • Excellent organizational, interpersonal, written, and verbal communication skills;
  • Familiarity with medical terminology and/or medical record review.
  • LPN Required

Home Office Requirements:

  • Reliable high-speed internet service
  • Minimum 25 Mpbs download speeds/50 Mpbs for shared internet connectivity
  • Minimum 5 Mpbs upload speeds

Minimum Requirements

Minimum Requirements:
- Bachelor's degree with 3 - 5 years of experience, OR Associate's degree with 5-7 years of experience.

  • RN preferred

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We're proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.

Job Summary

JOB TYPE

Full Time

SALARY

$125k-153k (estimate)

POST DATE

05/05/2024

EXPIRATION DATE

07/04/2024

Show more

Maximus Services, LLC
Full Time
$18-18 (estimate)
Just Posted
Maximus Services, LLC
Full Time
$146k-196k (estimate)
Just Posted
Csr
Maximus Services, LLC
Full Time
Just Posted

The job skills required for Nurse - Consultant include Health Care, Verbal Communication, etc. Having related job skills and expertise will give you an advantage when applying to be a Nurse - Consultant. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Nurse - Consultant. Select any job title you are interested in and start to search job requirements.

For the skill of  Health Care
My Medical Career
Full Time
$34k-41k (estimate)
3 Days Ago
For the skill of  Verbal Communication
UIC Technical Services
Full Time
$52k-77k (estimate)
Just Posted
Show more

The following is the career advancement route for Nurse - Consultant positions, which can be used as a reference in future career path planning. As a Nurse - Consultant, it can be promoted into senior positions as a Quality Assurance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Nurse - Consultant. You can explore the career advancement for a Nurse - Consultant below and select your interested title to get hiring information.

Forhyre
Full Time
$79k-99k (estimate)
2 Months Ago
Forhyre
Full Time
$104k-125k (estimate)
2 Months Ago