- Humana (Charleston, WV)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… 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
- Caris Life Sciences (WV)
- …and develop relationships to targeted National Payer key stakeholders from medical director , network management , and claims management . + Inform ... in-network contracts with National Payers. + Manage BCBS Caresourcing relationship. + With medical policy team, drive improved medical policies and adoption of… 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
- Genesis Healthcare (Huntington, WV)
- …AlignMed Partners is seeking a full-time (30-40 hours per week) Attending Physician/ Medical Director for our Heritage Center, located in Huntington, WV, ... salary for this position is $215000 / year. This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature. Must be BC/BE Internal Medicine… more
- Genesis Healthcare (Beckley, WV)
- …with potential and work-life balance flexibility! We are seeking a FFS Attending Physician/ Medical Director for split position between our Pine Lodge Center ... WV, and our Raleigh Center located in Daniels, WV. This is a Dual Role Attending Physician/ Medical Director . It is clinical in nature. Call is minimal as we have… more
- Humana (Charleston, WV)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- Genesis Healthcare (Charleston, WV)
- …contracted physicians, medical directors, contracted APPS, specialty consultants, medical director agreements with Operators/Centers. + Identifies, develops, ... to ensure a smooth onboarding process. + Identifies performance management opportunities with current providers, to include employed physicians,... medical directors. + Works closely with Regional Medical Director (RMD) to create a plan… more
- Evolent Health (Charleston, WV)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… 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
- Cardinal Health (Charleston, WV)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Sumitomo Pharma (Charleston, WV)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- Takeda Pharmaceuticals (Charleston, WV)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Evolent Health (Charleston, WV)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Evolent Health (Charleston, WV)
- …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
- HomeSafe Alliance (Charleston, WV)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Evolent Health (Charleston, WV)
- …leaders across the organization, training and development, provider relations, member services, claims management and our implementation team will also be ... plans and serves in a supporting role to the Director , Intake and Utilization Management Operations. +...population management or managed care/insurance or hospital medical management department setting may be substituted… more