- Highmark Health (Charleston, WV)
- …including the growing number of laws and regulations governing managed care organizations. The Manager , Medicaid Compliance & Operations acts as a trusted ... contracts. The position actively manages the day-to-day operations of the Medicaid Compliance Program, and contributes to the operational workflow for … more
- Humana (Charleston, WV)
- …development; and + Creating and executing comprehensive test plans + Ongoing Medicaid pricer maintenance, quality assurance, and compliance + Determining root ... a part of our caring community and help us put health first** The Medicaid (PPS) Provider Hospital Reimbursement Analyst also known as a Senior Business Intelligence… more
- Humana (Charleston, WV)
- …health outcomes for our dual members - members that qualify for both Medicare and Medicaid . The Lead Product Manager sits in the center of strategy, design, ... first** We are looking for a dynamic Lead Product Manager to develop clinical solutions for our members and...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- CVS Health (Charleston, WV)
- …and every day. **Position Summary** **Brief Overview** This is a Hybrid role. The Care Manager RN will be responsible to work from home as well as visit members ... homes. The Care Manager RN is responsible for driving and supporting care...the member's goals. + Utilizes care management processes in compliance with regulatory and company policies and procedures. +… more
- Highmark Health (Charleston, WV)
- …related field and 3 years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations. OR + Bachelor's degree in Social Work with five ... years' experience in Acute or Managed Care/ experience with Medicaid or Medicare populations **Preferred** + Experience working with high-risk pregnant women OR… more
- Humana (Charleston, WV)
- …we expand our cloud capabilities, we are looking for a Principal Product Manager to lead our multi-CSP strategy, drive cross-domain collaboration, and optimize our ... customer onboarding experience. As a Principal Cloud Platform Product Manager , you will own the vision, strategy, and execution for our multi-cloud platform-focusing… more
- Datavant (Charleston, WV)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Analytics Products, you will contribute to the strategy and ... and support value-based client delivery across Medicare Advantage, ACA, and Medicaid programs. The ideal candidate combines deep healthcare analytics expertise with… more
- CVS Health (Charleston, WV)
- …all with heart, each and every day. Travel: _Up to 25%_ The Care Manager BH is responsible for driving and supporting care management and care coordination ... gaps in care and access. + Using a holistic approach consults with manager , medical directors, and/or other physical/behavioral health support staff and providers to… more
- Cognizant (Charleston, WV)
- **Credentialing Account Manager (remote)** **This is a remote position open to any qualified applicant in the United States.** **Summary:** The Credentialing Account ... Manager oversees the end-to-end credentialing process for healthcare providers,...coordinates with internal teams to resolve issues and maintain compliance . **Key Responsibilities:** + Act as the primary liaison… more
- CVS Health (Charleston, WV)
- …of Care: - Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. ... Suite applications (Outlook, Word, Excel, SharePoint, Teams) **Preferred Qualifications** * Medicaid experience. * Waiver experience * Foster care experience *… more
- Humana (Charleston, WV)
- …plans. Key Accountabilities We are seeking a highly skilled Lead Digital Program Manager to oversee the development and execution of a new eCommerce business. This ... independently, ensuring alignment with strategic objectives. The Lead Digital Program Manager will play a key role in establishing the structure, frameworks,… more