- CommuniCare Health Services Corporate (Charleston, WV)
- Medical Director - Physician Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and ... Communities throughout Ohio, Indiana, West Virginia, Virginia, Missouri, Pennsylvania and Maryland. As Medical Director , you will be part of an exciting new… more
- Genesis Healthcare (Hurricane, WV)
- …and work-life balance flexibility, with no weekends! We are seeking a FFS Attending Physician / Medical Director for our Putnam Care Center, located in ... Hurricane, WV. This is a Dual Role Attending Physician / Medical Director . It is clinical in nature. There is flexibility with the schedule. Must be BC/BE… more
- Genesis Healthcare (Hurricane, WV)
- …and work-life balance flexibility, with no weekends! We are seeking a FFS Attending Physician / Medical Director for our Putnam Care Center, located in ... Hurricane, WV. This is a Dual Role Attending Physician / Medical Director . It is clinical in nature. There is flexibility with the schedule. Must be BC/BE… more
- Genesis Healthcare (Sissonville, WV)
- …center specific goals and priorities. The Advanced Practice Provider collaborates with the Medical Director and/or Attending Physician for patient specific ... this position is $93500 - $110000 / year. AlignMed Partners is a national medical group dedicated to improving health outcomes among residents of skilled nursing and… more
- Evolent (Charleston, WV)
- …business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Medical Director for MSK Surgery is a key member of the Medical ... including development of questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into the types of cases… more
- Humana (Charleston, WV)
- …and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, ... 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… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and ... health, DME, skilled nursing facility and waiver requests. The Medical Director provides medical interpretation...other team members, other departments, Humana colleagues and the Director of Physician Leadership. After completion of… more
- Humana (Charleston, WV)
- …and outpatient services and equipment, within their scope. The Medical Director may speak with contracted external physicians, physician groups, facilities, ... a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make… 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. ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. As well as,...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Charleston, WV)
- …mission. Stay for the culture. **What You'll Be Doing:** As a Vascular Surgery, Field Medical Director you will be a key member of the utilization management ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will...per inter-rater reliability process. + May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Charleston, WV)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , Oncology, you will be a key member of the utilization management ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. **What You Will...timely and accurate manner. . May assist the Senior Medical Director in research activities/questions related to… more
- Evolent (Charleston, WV)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Field Medical Director , MSK Surgery you will be a key member of the utilization ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. What You Will...timely and accurate manner. + May assist the Senior Medical Director in research activities/questions related to… more
- Highmark Health (Charleston, WV)
- …**Job Description :** **JOB SUMMARY** This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- CVS Health (Charleston, WV)
- …**This role is responsible for ensuring the accuracy and compliance of medical claims, which involves applying various editing rules and guidelines to ensure ... proper coding and payment. The lead director manages a team of claim editors, develops and...execution and delivery of new edits + Ensure that medical claims are reviewed and edited according to established… more
- Cardinal Health (Charleston, WV)
- …Specialty Networks works with over 11,500 providers across 3500+ independent specialty physician practices and now over 850 members. Furthermore, this business unit ... lead generation and contract reviews in collaboration with our Director , Member Development. This person will assist in presenting...+ Ability to navigate a high-level conversation with a physician at a Urology practice, required. + Willingness to… more
- Zimmer Biomet (Charleston, WV)
- …pushing the boundaries of innovation and driving our mission forward. As a global medical technology leader for nearly 100 years, a patient's mobility is enhanced by ... and threats. + Lead field marketing efforts tied directly to product goals assigned by Director of Total Ankle + Data gathering on company customers as to how they… more