• Clinical Investigation Lead

    Humana (Charleston, WV)
    …driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide strategic direction to drive ... owners across Humana to drive solutions forward. In this role you will lead quantitative and qualitative investigations to identify actionable insights and bring… more
    Humana (11/09/24)
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  • Nurse and CPC - Clinical Fraud Investigator…

    Elevance Health (Charleston, WV)
    …prior to payment. Researches new healthcare-related questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other ... evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims...experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or… more
    Elevance Health (10/01/24)
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  • Clinical Provider Auditor II

    Elevance Health (Charleston, WV)
    ** Clinical Provider Auditor II** **Supports the Payment Integrity line of business** _Location: This position will work a hybrid model (remote and office). The ideal ... determined to recover, eliminate and prevent unnecessary medical-expense spending. The ** Clinical Provider Auditor II** is responsible for identifying issues and/or… more
    Elevance Health (11/13/24)
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  • Director of Quality and Risk

    LifePoint Health (Beckley, WV)
    …development of corrective action plan.Formulates analysis plan for data managementOversees investigations of incidents that could lead to professional/general ... Officer. Achieves shared operational management among leadership, medical staff, and clinical employees to continually improve patient care outcomes. Implements the… more
    LifePoint Health (08/21/24)
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  • Medical Scientific Liaison, Solid Tumor - Denver,…

    Takeda Pharmaceuticals (Charleston, WV)
    …identifying, evaluating, and screening qualified research sites for company sponsored clinical investigation + Actively participates in executing USMAO strategy ... molecular pathways, mechanism of action Takeda Oncology products including clinical outcomes and research opportunities. + Formulate and keep...at medical conferences and may "co- lead " a medical conference to inform for being a… more
    Takeda Pharmaceuticals (10/12/24)
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  • Wound Care Coordinator - RN

    Genesis Healthcare (Parkersburg, WV)
    …regulatory wound care requirements will be provided) *Knowledge and experience with clinical charting, incident reporting and investigation response is required. ... looking for full time, day shift, skin health team lead / wound care coordinator for our geriatric /...with nursing center management.*Support central supply serving as the clinical expert for skin, wound, and incontinent products.*Oversee durable… more
    Genesis Healthcare (10/30/24)
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  • Supervisory Medical Administration Specialist

    Veterans Affairs, Veterans Health Administration (Huntington, WV)
    …by the Administrative Officer of the Day (AOD) as well as to the lower lead positions. The incumbent provides a high level of administrative support to the Business ... Office, upper management and clinical services. The primary supervisory function of this position...administrative operations and to provide support to the section's lead positions. The incumbent has full responsibility for organizing,… more
    Veterans Affairs, Veterans Health Administration (11/02/24)
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