- Elevance Health (Charleston, WV)
- ** Medicare Medical Director - Part time** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and ... be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible...specific position is $125,118 to $214,488. Prorated based on part -time hours. Locations: Illinois, Washington DC, New York In… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director (CMD) relies on medical background to review health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and/or Commercial products + Must be passionate… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Corporate Medical Director relies on medical background and reviews health ... claims and preservice appeals. The Corporate Medical Director works on problems of diverse...experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Must be… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...materials, internal teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and … more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews health claims. The ... Medical Director work assignments involve moderately complex to complex issues...group practice management. + Utilization management experience in a medical management review organization, such as Medicare … more
- Evolent (Charleston, WV)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... on-going training per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to the Utilization… more
- Evolent (Charleston, WV)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Field Medical Director you will be a key member of the utilization management team. ... per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- Evolent (Charleston, WV)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director you will be a key member of the utilization management team. ... timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… more
- CommuniCare Health Services Corporate (Charleston, WV)
- …Communities throughout Ohio, Indiana, West Virginia, Virginia, Missouri, Pennsylvania and Maryland. As Medical Director , you will be part of an exciting ... Medical Director - Physician Since 1984,...+ Health care management/leadership experience + Familiarity with CMS, Medicare Advantage, SNP Rules and Regulations + HCC and… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us...high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). The CMS Stars quality ... rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40...management, health outcomes, patient experience, and plan operations. The Director , Stars HOS Improvement and Operations is responsible for… more
- Evolent (Charleston, WV)
- …Stay for the culture. **What You'll Be Doing:** Evolent is seeking an **Associate Medical Director - Cardiovascular Medicine** to play a critical role in ... in Cardiology** (with Cardiology training and clinical experience). + **Unrestricted medical license** in the state of residence and willingness to obtain… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Lead, Data Quality/Integrity understands end-to-end master data processes and flows and ... diverse scope and complexity ranging from moderate to substantial. The Associate Director , Data Quality/Integrity will lead and manage the HEDIS Supplemental Data… more
- Genesis Healthcare (Dunbar, WV)
- …**Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part -Time team members. + **Support for New Grads & Clinical Fellows:** Our Powerback ... about making a meaningful difference and want to be part of the future of rehabilitation and wellness, Powerback...Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of… more
- Evolent (Charleston, WV)
- …as we solve complex business problems. **Collaboration Opportunities:** The Director , Actuarial Services utilizes and develops analytical tools to solve ... impact on the organization and patient health. This role supports both medical cost management activities and business development efforts. **What You Will Be… more
- CenterWell (Charleston, WV)
- **Become a part of our caring community and help us put health first** The IPA Coding Leader manages a diverse team responsible for ensuring clinical documentation ... Leaders to identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying business partner… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Print Project Manager 2 will report to the Associate Director of Enterprise Print ... into new processes; flexibility in job focus. + Understanding of Centers for Medicare & Medicaid Services (CMS) guidelines. Travel: While this is a remote position,… more
- Humana (Charleston, WV)
- …**Reporting Relationship:** This position reports directly to the Behavior Health Lead Medical Director . **Requirements:** . BCBA-D with Florida licensure or ... **Become a part of our caring community and help us...skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Senior Utilization… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** Humana's Primary Care Organization (PCO) is seeking a Senior Product Marketer will play a ... tactics to enhance brand visibility and event planning. Reporting to the Associate Director of Center Expansion Marketing, you will be responsible for developing and… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The IT Infrastructure Procurement Category Manager will report directly into the Director ... savings goals. + Leverage internal and external resources, as part of the operating model, to deliver results in...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more