Top 2748 Federal contractor Jobs in Maryland

Referral Management (Non-Nurse) Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $23.56 an hour
- Microsoft Excel
- Microsoft Outlook
- Customer service
Referral Management (Non-Nurse) Reviewer
Zimmerman Associates, Inc. —Bethesda, MD
- $24.13 an hour
- Microsoft Excel
- Microsoft Outlook
- Customer service
Maintenance Technician
Addison Group —Bethesda, MD
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Project Manager
Leidos —Odenton, MD
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Project Manager
Leidos —Odenton, MD
- $116,350 - $210,325 a year
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Operations Coordinator - NIH
Global Solutions Network Inc —Bethesda, MD
- $37.28 - $43.35 an hour
- Full-time
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- 3 years
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Administrative Assistant - NIH
Global Solutions Network Inc —Bethesda, MD
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Grant Management Specialist - NIH
Global Solutions Network Inc —Bethesda, MD
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Operation Administration Support Specialist – Federal Client
The Concourse Group LLC —Columbia, MD
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11d
DHS Record Searcher
Information Systems & Networks Corporation —Bethesda, MD
- $50,000 - $60,000 a year
- Remote
- Mid-level
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Administrative Specialist - Federal Client
The Concourse Group LLC —Columbia, MD
- $39.97 - $40.50 an hour
- Full-time
- Hybrid work
- Writing skills
- Mid-level
- High school diploma or GED
- Health savings account
- Paid holidays
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11d
Personnel Security Analyst
AQIWO, Inc. —Rockville, MD
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Telework US Government Grants Management Specialist / Grants Support Specialist
Arcetyp LLC —Bethesda, MD
- Full-time
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- Microsoft Outlook
- Mid-level
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Grant Management Specialist
Global Solutions Network Inc —Bethesda, MD
- $120,000 - $145,000 a year
- Full-time
- Mid-level
- Analysis skills
- Bachelor's degree
- Travel reimbursement
- Profit sharing
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Security Assistant
Armada Ltd —Naval Air Station Patuxent River, MD
- From $47.50 an hour
- Full-time
- Microsoft Access
- Microsoft Outlook
- Mid-level
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Executive Assistant
Global Solutions Network Inc —Bethesda, MD
- $37.50 - $45.83 an hour
- Full-time
- Office
- Databases
- Senior level
- Travel reimbursement
- AD&D insurance
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Grounds Maintenance Laborer - TS/SCI
LAUKOA —Fort Meade, MD
- $50 - $60 an hour
- Full-time
- 1 year
- Communication skills
- Entry level
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FOIA Analyst
Contact Government Services, LLC —Rockville, MD
- $75,000 - $125,000 a year
- Full-time
- Remote
- 6 years
- English
- Senior level
- Health insurance
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Administrative Specialist II
GAP SOLUTIONS INC —Bethesda, MD
- $38 - $48 an hour
- Email
- Customer service
- Mid-level
- Office
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Personnel Security Specialist
Information Systems & Networks Corporation —Bethesda, MD
- Full-time
- Mid-level
- Office
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Referral Management (Non-Nurse) Reviewer

Zimmerman Associates, Inc. -
Bethesda, MD

Apply Now

Job Details

$23.56 an hour

Qualifications

Customer communication
Microsoft Excel
Microsoft Outlook
Customer service
Associate's degree
Medical terminology

Full Job Description

Zimmerman Associates, Inc. (ZAI) is seeking to hire multiple Referral Management (Non-Nurse) Reviewers to support our contract with the Integrated Referral Management and Appointing Center (IRMAC), the National Capital Region’s premier authority for appointment coordination and referral management services for beneficiaries within the Defense Health Network.

Pay Rate: $23.56 per hour plus $4.93 Health & Wellness Fringe

Role and Responsibilities:

Referral Management (Non-Nurse) Reviewers will facilitate centralized product line and specialty referrals for Active-Duty Service Members and TRICARE Prime beneficiaries enrolled at Military Treatment Facilities (MTFs) within the National Capital Region.

This is an onsite opportunity

Qualifications / Skills / Experience:

Minimum of an Associate’s degree
At least 2 years of experience in Utilization Management, Referral Management, Authorization/Denials, or Medical Claims Processing/Insurance Referral
U.S. Citizenship required, with the ability to obtain a Public Trust Clearance
Knowledge of medical care criteria such as InterQual, Milliman Ambulatory Care Guidelines, Specialty Referral Guidelines (SRGs), or other evidence-based Military Health System (MHS) guidelines
Familiarity with medical terminology and ability to learn MHS, VA-DOD Sharing Program, TRICARE, HIPAA, and release of medical information protocols
Excellent communication and interpersonal skills
Strong customer service orientation
Understanding of Access to Care Standards within the Direct Care System
Attention to detail, including correct use of deferral codes
Strong organizational skills with ability to prioritize tasks and manage time effectively
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Access, Outlook) and internet navigation

Essential Tasks:

Review and process referrals for administrative and clinical completeness and appropriateness, completing disposition within 24 hours of referral date
Collaborate with appointing centers, case managers, product line nurses, providers, clinics, managed care contractors, and other healthcare team members to ensure appropriate use of Direct Care and civilian network resources
Ensure patients are scheduled with the right provider, at the right time and place
Review compliance with Specialty Referral Guidelines (SRGs) per IRMAC protocols
Complete and return Clear Legible Reports (CLR) to ordering civilian providers within required Return of Favorable Response (ROFR) timelines
Manage telephone, written, and electronic communications regarding specialty appointments and referrals
Monitor and process referral management worklists (e.g., Genesis Work Lists) to ensure timely consult processing
Communicate referral status to patients, including benefit counseling and advocacy resources as needed
Reschedule or redirect patients within 3 days when referrals are disapproved or invalid, advising on other care options and Line-of-Duty issues
Receive and enter ROFR referrals in MHS-GENESIS from Military Contractor Support Centers (MCSC) portals for assigned specialties/product lines, adhering to all timelines and business rules
Verify patient eligibility and update demographics in MHS-GENESIS
Document patient interactions, especially when appointments are refused, and coordinate with Beneficiary Counselor and Assistance Coordinator as appropriate
Coordinate with product line nurses and clinics for special accommodations
Interface with MCSC and multidisciplinary teams to ensure referral appropriateness
Submit referrals to non-network providers for TRICARE Service Center medical necessity reviews
Monitor referral management voicemail and return patient calls within established guidelines
Provide External Provider Referral Online (EPRO) information as requested
Close unused referrals following DHA IPM and NCR Medical Directorate policies, notifying ordering providers accordingly
Orient and train new IRMAC staff on referral processes and timelines
Perform other duties as assigned

Zimmerman Associates, Inc. is an equal opportunity employer. We comply with Federal and State Equal Opportunity laws and consider qualified applicants without regard to race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, veteran status, or any other protected status.

#INDSPN

Apply Now

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federal contractor jobs in maryland

Referral Management (Non-Nurse) Reviewer

Referral Management (Non-Nurse) Reviewer

Maintenance Technician

Project Manager

Project Manager

Operations Coordinator - NIH

Administrative Assistant - NIH

Grant Management Specialist - NIH

Operation Administration Support Specialist – Federal Client

DHS Record Searcher

Administrative Specialist - Federal Client

Personnel Security Analyst

Telework US Government Grants Management Specialist / Grants Support Specialist

Grant Management Specialist

Security Assistant

Executive Assistant

Grounds Maintenance Laborer - TS/SCI

FOIA Analyst

Administrative Specialist II

Personnel Security Specialist

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