- CVS Health (Charleston, WV)
- …management and clinical coverage and policies. **Primary Job Duties & Responsibilities:** Behavioral Health Medical Director + Collaborates with health ... This person will oversee and be responsible for all behavioral health activities in the health...tactics, policies, and programs that drive the delivery of quality behavioral healthcare to establish competitive business… more
- Humana (Charleston, WV)
- …while ensuring attainment of quality of care and financial goals. The Behavioral Health Medical Directors support Humana values, and Humana's Bold Goal ... focus on collaborative business relationships, value-based care, quality metrics, population health , and disease or care management. The Behavioral Health… more
- Highmark Health (Charleston, WV)
- …High School Diploma/GED with RN license or Master's Degree if licensed behavioral health professional **Substitutions** + None **Preferred** + Bachelor's degree ... Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the delivery of ...years of post licensure experience in a combination of Behavioral Health Clinical, Case Management and/or Condition… more
- Elevance Health (Charleston, WV)
- **Sign-on Bonus:** $3,000 The ** Behavioral Health Case Manager II** is responsible for performing case management telephonically and/or by home visits within the ... scope of licensure for members with behavioral health and substance abuse or substance...not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will… more
- Humana (Charleston, WV)
- …community and help us put health first** The Care Manager, Telephonic Behavioral Health 2, in a telephonic environment, assesses and evaluates members' needs ... care and wellbeing of members The Care Manager, Telephonic Behavioral Health 2 is a **Licensed,** **Master...bi-weekly stipend for their internet expense + Humana will provide Home or Hybrid Home/Office associates with telephone equipment… more
- Highmark Health (Charleston, WV)
- …budgetary responsibility and authority. + Develop, implement and execute, the Provider STARs quality strategy, support/develop technology and data strategies ... provider -based and internal Organization committees to advance member health and service outcomes. This involves action plan development, timelines, large-scale… more
- Public Consulting Group (Charleston, WV)
- …potential clients with a particular focus on state Medicaid agencies, children's behavioral health , child welfare and juvenile justice Agencies, HHS agencies, ... growth and development. + Delegate tasks effectively, monitor team performance, and provide feedback to ensure high- quality project outcomes. + Foster a… more
- Humana (Charleston, WV)
- …a social determinant of health (SDOH) flag in the EMR + Assesses behavioral health integration readiness of ACO physician practices + Leads the design of ... part of our caring community and help us put health first** The Delaware Valley ACO (DVACO) is an...Coordination, Practice Transformation, Data Analytics, Post-Acute Care and Clinical Quality , and the opportunity to become acquainted with each… more
- Intermountain Health (Charleston, WV)
- …through medical staff office and peer review requirements may apply if working in the behavioral health setting. + May provide support and debriefing, in ... care appropriate care team, assess crisis situations to appropriately provide needed resources and or referrals for the patient,...the process to complete prior to starting. _Connect Care- Behavioral Health is a fully virtual outpatient… more
- BrightSpring Health Services (Scott Depot, WV)
- …Community Living, Adult Host Homes for adults regardless of disability, Behavioral /Mental Health Support, In-home Pharmacy Solutions, Telecare and Remote ... patients' expectations. If you're motivated to give our clients a more positive quality of life we encourage you to apply today! Responsibilities Behavior Support… more
- Highmark Health (Charleston, WV)
- …personal health goals. The incumbent monitors, improves and maintains quality outcomes (clinical, financial and functional) for the specified panel of members. ... any combination of clinical, case management and/or disease/condition management experience, provider operations and / or health insurance experience… more
- Highmark Health (Charleston, WV)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job is responsible for leading large projects and initiatives related to the risk case ... management and intake activities of Highmark Health in support of a broad range of frameworks and oversight bodies including NIST, HITRUST, PCI, HIPAA, SOC, MAR,… more
- Highmark Health (Charleston, WV)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** Entirely Remote Work From Anywhere Role! We are seeking an experienced AI/ML/Software Cloud ... create innovative products and services. **ESSENTIAL RESPONSIBILITIES** + Lead to provide strategic consultation to business customers in defining or designing… more
- Intermountain Health (Charleston, WV)
- **Job Description:** The Connect Care- Behavioral Health Clinical Social Worker utilizes clinical expertise to perform psychosocial assessments, implement plans ... so they can self-manage their care, optimize their functional health status, have quality outcomes, and use...role will be a part of the Connect Care- Behavioral Health Team. Looking for a candidate… more
- Humana (Charleston, WV)
- … Improvement, Utilization Management, Population Health , Social Determinants of Health , Pharmacy, Behavioral Health , Institutional Long-Term Services and ... **Become a part of our caring community and help us put health first** Humana Healthy Horizons is seeking a Capture Lead, Clinical & Population Health Strategy,… more
- Intermountain Health (Charleston, WV)
- …through medical staff office and peer review requirements may apply if working in the behavioral health setting. + Acts as an advocate on behalf of patients and ... Completes comprehensive assessments of patients in hospital settings experiencing a mental health crisis. They utilize their clinical expertise to develop care plans… more
- Highmark Health (Charleston, WV)
- …screening, reviewing, evaluating online entry, correcting errors and/or performing quality control review and final adjudication of paper/electronic claims. ... claims adjustments which could be a result of internal/external audits, member/ provider phone calls, other insurance information received, appeals, and system… more
- Sevita (Charleston, WV)
- …such as individuals with a developmental disability, brain injury, or mental health ; expertise in special disciplines such as behavioral support, early ... our team -** **_Apply Today!_** Sevita is a leading provider of home and community-based specialized health ...deserves to live a full, more independent life. We provide people with quality services and individualized… more
- Highmark Health (Charleston, WV)
- …:** Endorsed **Job Description :** **GENERAL OVERVIEW** The Medical Director will provide qualified medical direction and consultation for care delivery and complex ... for our community-based palliative care program. In addition, this role will provide clinical leadership and guidance to the regional interdisciplinary team. The… more
- Highmark Health (Charleston, WV)
- …and using that knowledge to design and implement data management solutions. + Provide business process, system support and data quality governance through data ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** CANDIDATE MUST...management solutions. Provides business process, system support and data quality governance through data coordination and integration to ensure… more