- Elevance Health (Charleston, WV)
- ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
- Humana (Charleston, WV)
- …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)
- …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)
- …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 ... questions. + Reviews statistical sample of cases for Field Medical Director audits and makes recommendations into...by any state or federal health care program, including Medicare or Medicaid, and is not identified as an… 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)
- …in a non-clinical setting? Join our Utilization Management team as a Field Medical Director , Cardiovascular Specialist and use your expertise in interventional ... 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)
- …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 ... 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
- 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)
- Medical Director - Physician Since 1984, CommuniCare Health Services has provided superior, comprehensive management services for the development and management ... Indiana, West Virginia, Virginia, Missouri, Pennsylvania and Maryland. As Medical Director , you will be part of...+ Health care management/leadership experience + Familiarity with CMS, Medicare Advantage, SNP Rules and Regulations + HCC and… more
- Humana (Charleston, WV)
- …our customers and delivering 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)
- …Humana's Marketing organization is seeking a dynamic and experienced Associate Director of Marketing Campaign Management to join the Marketing, Regulatory and ... working remote anywhere in the US. Reporting to the Director of Production, you will lead a team supporting...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Humana (Charleston, WV)
- …health first** Humana's Marketing organization is seeking a dynamic and experienced Director of Marketing Campaign Management to join the Marketing, Regulatory and ... Stars, Wellness/Go365, Medicaid, Onboarding and Specialty product lines. As the Director , Marketing Campaign Management, you will plan, recommend and implement… more
- Humana (Charleston, WV)
- …well-being and overall experience with our products. As the Associate Director of DevOps Platforms in the Enterprise Engineering Enablement organization, you ... Work Arrangements Available **Reporting Information** + You'll report to the Director of Enterprise DevOps and Enterprise Engineering Enablement. + You'll be… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Director , Product Management Leads all phases of the product life cycle, from inception to ... as a 5 member team of Agile coaches. The Director , IT Product Management works with relevant Humana stakeholders...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Genesis Healthcare (Dunbar, WV)
- …Powerback is the place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time team members. + **Support ... Clinicians in Action professional development program. Responsibilities As a Director of Rehabilitation, you are leading a team of...in the state of practice 3. Thorough knowledge of Medicare and third party billing required 4. Must have… 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