• Social Services Care Manager

    Humana (Charleston, WV)
    **Become a part of our caring community and help us put health first** The Care Manager , Telephonic Behavioral Health 2, in a telephonic environment, ... for the care and wellbeing of members. The Care Manager , Telephonic Behavioral Health 2 is a **Licensed,** **Masters level, social worker** who… more
    Humana (03/20/25)
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  • Manager , Utilization Management…

    Humana (Charleston, WV)
    …a part of our caring community and help us put health first** The Manager , Utilization Management Behavioral Health utilizes behavioral health ... communication of medical services and/or benefit administration determinations. The Manager , Utilization Management Behavioral Health ...millions of people we serve to achieve their best health - delivering the care and service… more
    Humana (03/12/25)
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  • LCSW Behavioral Health Educator

    CenterWell (Charleston, WV)
    …as train our staff in normalizing having conversations with patients on end-of-life goals of care . The LCSW Behavioral Health educator will also be a subject ... and MSW job profile content areas: behavioral health assessments and plans, collaborative care model...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (03/04/25)
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  • Social Work Care Manager

    Intermountain Health (Charleston, WV)
    …and provides short term treatment planning for mental, emotional and behavioral disorders, conditions and addictions. **Essentials:** + Participates in case reviews ... to evaluate care management and progress toward goals. Consults with healthcare team members to promote, monitor, and evaluate compliance with patient's treatment… more
    Intermountain Health (03/15/25)
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  • Nurse Manager / RN Required

    BrightSpring Health Services (Dunbar, WV)
    …area of responsibility. Responsible to supervise all nursing personnel, and ensure care and services are coordinated with behavioral and programmatic staff ... Community Living, Adult Host Homes for adults regardless of disability, Behavioral /Mental Health Support, In-home Pharmacy Solutions, Telecare and Remote… more
    BrightSpring Health Services (02/20/25)
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  • Case Manager , RN

    CAI (Charleston, WV)
    …implement and evaluate care for eligible members with chronic and complex health care , social service and custodial needs in a nursing facility or ... address the member's specific needs + Educate members or caregivers regarding health care needs, available benefits, resources and services including available… more
    CAI (02/01/25)
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  • Complex Case Manager RN (Remote)

    Highmark Health (Charleston, WV)
    …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
    Highmark Health (03/13/25)
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  • Medical Case Manager (West Virginia)

    Highmark Health (Charleston, WV)
    …complex medical and/or psychosocial needs have access to high quality, cost-effective health care . Assists in the holistic assessment, planning, arranging, ... understanding of illness/disease impact and to positively impact member care plan adherence, pharmacy regimen maintenance, and health...position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
    Highmark Health (03/19/25)
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  • Program Manager

    Highmark Health (Charleston, WV)
    …nationally recognized commitment to promote living health , inclusive of individuals' social health . The Program Manager will be an integral part of Highmark ... **Company :** Highmark Health **Job Description :** **GENERAL OVERVIEW** Highmark ...develop and implement SDOH programs that remove barriers to care and help people thrive, support evaluation frameworks to… more
    Highmark Health (03/15/25)
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  • Category Manager

    Highmark Health (Charleston, WV)
    …management and performance **Preferred** + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
    Highmark Health (02/18/25)
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  • Residential Manager

    BrightSpring Health Services (Summersville, WV)
    …environment + Monitors and ensures staff follows agency procedures to promote optimum health care and behavior supports + Monitors and ensures staff completes ... skills + Bachelor of Art/Bachelor of Science in Business, Health Care Administration or a Social Science...Living, Adult Host Homes for adults regardless of disability, Behavioral /Mental Health Support, In-home Pharmacy Solutions, Telecare… more
    BrightSpring Health Services (03/19/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Charleston, WV)
    …and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA ... Programs. Supports other key objectives designed to build/strengthen patient care delivery and capture of Risk Adjustment documentation/ reporting capabilities,… more
    Highmark Health (03/06/25)
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  • Youth Care Worker

    BrightSpring Health Services (St. Albans, WV)
    Our Company StepStone Family & Youth Services Overview The Youth Care Worker provides direct care to youth in a group home setting. The Youth Care Worker ... serves as a positive role model, implementing Trauma Informed Care and adherence of policies and procedures of the...to establish goals within milieu. Aids youths in learning behavioral expectations of program and making positive choices in… more
    BrightSpring Health Services (12/24/24)
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  • Managed Care Claims Validator / Biller

    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 ... the CommuniCare Family of Companies has been committed to delivering exceptional person-centered care as a national leader in post-acute care for those that… more
    CommuniCare Health Services Corporate (02/24/25)
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  • Market VP, Value-Based Care Business…

    CenterWell (Charleston, WV)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (03/14/25)
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  • Senior Strategy Professional, Specialty…

    CenterWell (Charleston, WV)
    …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager more
    CenterWell (03/19/25)
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  • Peer Support Specialist (Certification Required)

    Elevance Health (Charleston, WV)
    …self-advocacy. **Minimum Requirements:** + Requires AA/AS and minimum of 2 years of experience in health services or behavioral health field or in a peer ... The **Wellness & Recovery Specialist** is responsible for care coordination activities focused on the Wellness and...network. + Assist members in working with their case manager or treatment team in determining the steps he/she… more
    Elevance Health (02/08/25)
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  • Senior Application Developer (Person360 & MDM)

    Highmark Health (Charleston, WV)
    **Company :** Highmark Health **Job Description :** **JOB SUMMARY** We are on a mission to deliver remarkable health experiences, freeing people to be their ... requires an advanced 360 person-centered approach to deliver the right message, guidance, care , outcome, and experiences, all at the right time. This Sr Application… more
    Highmark Health (01/30/25)
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  • Medicaid Contract Director

    Highmark Health (Charleston, WV)
    …group. **ESSENTIAL RESPONSIBILITIES** + Manage and oversee the state's managed care organization (MCO) contractual performance as specified in the contract and ... and matrix aligned organizations + Previous consulting in a principle/ manager /director role; portfolio management experience + Strong communication and interpersonal… more
    Highmark Health (01/28/25)
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  • Wraparound Facilitator- 2K Sign on

    BrightSpring Health Services (Dunbar, WV)
    …at Home WV is to safely reduce reliance on in-state and out-of-state congregate care for youth ages 12-17. Safe at Home WV will provide for trauma-focused treatments ... family while building upon their strengths. Responsibilities + Consults with Program Manager regularly and as needed + Responsible for contract compliance and… more
    BrightSpring Health Services (01/22/25)
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