- Elevance Health (Charleston, WV)
- ** Medical Director - Medicare** Location: This...** is responsible for the administration of physical and/or behavioral health medical services, to ... opportunities. May serve as a resource to staff including Medical Director Associates. May be responsible for...For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years… more
- WestCare Foundation (Buckhannon, WV)
- Behavioral Health Technician Job Details Job...Job Functions: + Work under the supervision of Program Director . + Receive at least 4 hours of documented ... supervision monthly. + Have all treatment plans co-signed by Director . + Train new employees. + Assist in the...house meetings. + Transport to community appointments such as medical , dental or school, as needed. + Check and… more
- Highmark Health (Charleston, WV)
- …Patient care (hospital, outpatient, or private practice) **Preferred** + 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed ... current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and… more
- Otsuka America Pharmaceutical Inc. (Charleston, WV)
- …education, and activation, ultimately improving patient access and adherence. The Director will work cross-functionally with medical affairs, market access, ... The Director , Consumer Marketing is responsible for leading the...deep expertise in direct-to-consumer (DTC) marketing, omnichannel engagement, and behavioral insights to create impactful and compliant consumer campaigns.… more
- Highmark Health (Charleston, WV)
- …and lines of business. This will require aligning new models to the health plan's strategic objectives based on a deep understanding of innovation and industry ... Advanced Analytics, Contracting and Provider Relations, Actuary, Finance, Highmark Health Solutions, Health Plan Operations. **ESSENTIAL RESPONSIBILITIES** +… more
- BrightSpring Health Services (Bridgeport, WV)
- …community living, adult host homes for adults regardless of disability, behavioral /mental health support, in-home pharmacy solutions, telecare and remote ... the needs of our clients in a variety of settings such as Home Health , Hospice, Residential and Private Duty. If your passion is outstanding patient care coupled… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Director , Risk Adjustment Strategy Advancement will provide business intelligence and ... planning support for business segments and the company at large. The Director , Risk Adjustment Strategy Advancement requires an in-depth understanding of how… more
- CenterWell (Charleston, WV)
- …best care, when needed most, and for the lowest cost. We go beyond physical health - addressing the social, emotional, behavioral and financial needs that can ... part of our caring community and help us put health first** The IPA Coding Leader manages a diverse...identify and influence enhancements to technology to improve the medical coder experience. + Oversees coding operations by identifying… more
- BrightSpring Health Services (Dunbar, WV)
- …mortality reviews are completed within five days of death and submit to State Health Services Director and Assigned Director , Clinical Practice* Review ... community living, adult host homes for adults regardless of disability, behavioral /mental health support, in-home pharmacy solutions, telecare and remote… more
- CommuniCare Health Services Corporate (Charleston, WV)
- …conditions. Our more than 150 skilled nursing, assisted living, independent living, behavioral health , and long-term care facilities deliver sophisticated and ... Maryland, Virginia, West Virginia, Pennsylvania). Due to continued growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller… more
- Evolent (Charleston, WV)
- …as required. + Entering data into a proprietary system generating cases for both the medical and behavioral health reviewers. These requests may be submitted ... also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our... reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,… more