- Elevance Health (Charleston, WV)
- …+ New Jersey, Morristown **Description** **Clinical Operations Medical Director** ** Utilization Management of Medical Oncology Benefits** **Carelon Benefits ... as part of consideration for employment. **Medical Oncology Medical Director - Utilization Review** + Job Family: MED > Licensed Physician/Doctor/Dentist + Type:… more
- Fresenius Medical Center (Dunbar, WV)
- …and acts as the liaison for patient care as per the disease management agreement, including initial and ongoing validation of member eligibility. Facilitate timely ... workup of patients for access management , dialysis services, patient education, hospitalizations, and kidney transplantation as appropriate, and ensures coordination… more
- Elevance Health (Charleston, WV)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... state(s) required. **Preferred Skills, Capabilities, and Experiences:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- Sedgwick (Charleston, WV)
- …and Medicare Set-Aside Consultant Certified (MSCC) certification required. Certified Case Manager (CCM) or Certified Occupational Health Nurse designation ... to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Medicare Compliance Nurse Team Lead **PRIMARY PURPOSE** **:** To supervise Medicare Compliance… more
- Marriott (Charleston, WV)
- …Y **Relocation?** N **Position Type** Management **JOB SUMMARY** The Nurse CARE Manager coordinates timely, appropriate, quality, occupational illness/injury ... **Additional Information** Nurse CARE Manager (CARE - Coordinated...Claims Services + Collaborate with Claims department regarding case management . + Collaborate with UNM on utilization … more
- Elevance Health (Charleston, WV)
- …with telephonic assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social ... RN, member and the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current… more