The Health Plan of West Virginia Inc jobs in United States

Office Operations Coordinator

1 day ago

We are seeking an experienced Administrative Assistant to join our team at The Health Plan of West Virginia, Inc. As an Administrative Assistant, you will be responsible for providing administrative support to our office, including data entry, mail processing, and customer servic ...

Healthcare Utilization Reviewer

1 week ago

Key Responsibilities: · * Conduct thorough reviews of hospital admissions, identifying areas for improvement and developing strategies to enhance quality of care · * Collaborate with healthcare providers and patients to develop personalized care plans, ensuring that each individu ...

Medical Record Abstractor Specialist

5 days ago

The Health Plan of West Virginia, Inc. is seeking a skilled Medical Record Abstractor Specialist to join our team. · Job Summary: · This position is responsible for conducting data collection and abstraction of medical records for various projects and initiatives, ensuring accura ...

Plan Design and Implementation Professional

16 hours ago

Job Overview · The Health Plan of West Virginia Inc is seeking a highly skilled Benefits Analyst to join our team. In this role, you will be responsible for designing and implementing new and existing health insurance benefit plans. · Key Responsibilities: · Design and implement ...

Support Services Assistant

15 hours ago

Required Skills and Qualifications · Education: High school graduate or equivalent, with work experience. · Communication Skills: Strong verbal and written communication skills, with excellent phone etiquette. · Organizational Skills: Ability to multitask, prioritize tasks, and m ...

Clinical Data Abstractor

22 hours ago

Job Description · The Health Plan of West Virginia Inc is seeking a Clinical Data Abstractor to join our team. As a key member of our quality improvement initiatives, you will be responsible for conducting data collection and abstraction of medical records for HEDIS projects, sup ...

Grievance and Appeal Coordinator - Researcher

8 hours ago

About Us · The Health Plan of West Virginia Inc is a leading health insurance provider dedicated to delivering high-quality care to our members. Our mission is to provide innovative solutions that improve the health and well-being of our community. · We are seeking a highly skill ...

Stop Loss Analyst

23 hours ago

Job Overview · The Stop Loss Analyst plays a crucial role in collaborating with Reinsurance Carriers to secure reimbursement for groups that have exceeded the Specific Stop Loss deductible. This involves working closely with The Health Plan's Account Executives, Claims Team, Fina ...

Director, Case Management

1 week ago

Job Title: Director of Case Management · Summary: · The Director of Case Management is responsible for providing leadership and management oversight to ensure the quality provision of member-driven care continuum programs. This includes ensuring delivery of essential services tha ...

Director of Care Continuum Development

1 week ago

About Us · The Health Plan of West Virginia, Inc. is a leading healthcare organization dedicated to providing high-quality care continuum services to its members. Our team is passionate about improving health outcomes and delivering exceptional patient experiences. · Our Mission: ...

Administrative Assistant

2 days ago

Job Summary: · We are seeking an administrative professional to assist with the administration of two trusts: the UMWA 1985 Construction Workers Pension Plan and the 1978 Retired Construction Workers Benefit Trust. · Key Responsibilities: · Outgoing Mailings: Processing and sendi ...

Reinsurance Filing Analyst

16 hours ago

Job Overview · The Health Plan of West Virginia Inc is seeking a highly motivated and detail-oriented individual to fill the role of Stop Loss Claims Specialist. In this position, you will work closely with our Reinsurance Carriers to ensure timely and accurate reimbursement for ...

Receivables Collections Specialist

11 hours ago

About the Role · We are seeking a highly motivated and detail-oriented individual to fill the position of Receivables Collections Specialist. The successful candidate will be responsible for managing all aspects of account receivable processes, including invoicing, collections, a ...

Nurse Care Coordinator

20 hours ago

Job Overview · ">">The Health Plan of West Virginia Inc seeks a highly skilled and dedicated Nurse Navigator to join our team. As a key member of our healthcare team, you will be responsible for coordinating care and services for our members, ensuring they receive the best possib ...

Health Insurance Benefits Coordinator

12 hours ago

Job Summary · As a Benefits Analyst at The Health Plan of West Virginia Inc, you will play a critical role in designing and implementing new and existing health insurance benefit plans. This position requires a strong understanding of plan design and the ability to work independe ...

Benefits Analyst

23 hours ago

Job Summary · This role involves the accurate and timely implementation, development, and maintenance of new and existing benefit plans in the claims processing system to maximize automatic claim adjudication potential. · Key Responsibilities · Primary duties include: · Building ...

Healthcare Documentation Coordinator

4 days ago

The Health Plan of West Virginia, Inc. is seeking a detail-oriented Healthcare Documentation Coordinator to support our quality improvement initiatives. · About the Position: · This role involves coordinating outreach efforts, abstracting medical records, and documenting chart au ...

Deductible Management Expert

12 hours ago

Responsibilities · The Stop Loss Claims Specialist is responsible for maintaining a positive working relationship with colleagues, clients, and vendors. This involves communicating effectively in a timely and professional manner, as well as ensuring confidentiality of member prot ...

Quality Coordinator

23 hours ago

Job Title · Quality Improvement Specialist · Summary · Under the direction of the Director, Quality Improvement, this role is responsible for assisting with administering and monitoring plan-wide Quality Improvement & Quality Management initiatives and compliance related to NCQA ...

Clinical Navigator

19 hours ago

About The Role · The Health Plan of West Virginia Inc is seeking a skilled Clinical Navigator to join our team. As a Clinical Navigator, you will play a crucial role in coordinating patient care and ensuring seamless transitions between healthcare settings. · Key Responsibilities ...