- Ryder System (Charleston, WV)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
- CommuniCare Health Services Corporate (Charleston, WV)
- …posting team, Business Office Manager, Regional Director of Finance, MDS, Case Management , and others. The CBO claims validation staff will strive to always ... growth, CommuniCare Health Services is currently recruiting for a Claims Validator / Biller to support our Central Billing...of benefit options from life and disability plans to medical , dental, and vision coverage from quality benefit carriers.… more
- Humana (Charleston, WV)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Charleston, WV)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Charleston, WV)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- LifePoint Health (Beckley, WV)
- …and management of personnel within the Quality/Performance Improvement, Risk Management , and Medical Staff Office departments as well as effectively ... Patient Safety Officer and Ethics and Compliance Officer. Achieves shared operational management among leadership, medical staff, and clinical employees to… more
- CVS Health (Charleston, WV)
- …+ Innovation and ideation around new areas of data driven impact around medical cost and patient experience + Work closely with other development teams to ... experience in developing and operating innovative healthcare analytic solutions utilizing member, claims , clinical and provider data + 10+ years working with… more
- Trustmark (Charleston, WV)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
- Genesis Healthcare (Hurricane, WV)
- …work-life balance flexibility, with no weekends! We are seeking a FFS Attending Physician/ Medical Director for our Putnam Care Center, located in Hurricane, WV. ... $215000 / year. This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature....within the Compliance Process, Standard/Code of Conduct, Federal False Claims Act and HIPAA. Participate in required orientation and… more
- UMB Bank (Charleston, WV)
- …across all payment channels. Will work with the Enterprise Fraud Prevention and Claims teams to provide data to help identify emerging fraud trends and UMB's ... concert with the Enterprise Fraud Prevention and Enterprise Fraud Claims teams to identify fraud exposure and make necessary...to fulfill overall business needs and expectations of the Director of Enterprise Fraud Operations and the bank's senior… more
- Cardinal Health (Charleston, WV)
- …on policies. **_Manager, Ethics and Compliance_** Reporting to the Compliance Director , this position is responsible for supporting the programmatic requirements for ... focus include: compliance training, policy development, exclusion screening tracking, management of investigations and development of programmatic presentation materials.… more