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The Health Plan of West Virginia Inc in United States

26 jobs at The Health Plan of West Virginia Inc in United States

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  • The Health Plan of West Virginia, Inc.

    Compliance Support Coordinator

    1 week ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    The Compliance Support Coordinator is expected to provide the Compliance Manager and Government Compliance Officer with administrative and organizational support. The Compliance Support Coordinator is expected to complete tasks as assigned and perform additional duties as deemed ...

  • The Health Plan of West Virginia, Inc.

    Practice Management Consultant

    4 hours ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    Under the direction of the Director, Provider Network Management, the Practice Management Consultant provides education, training and guidance for providers in the assigned provider network; drives quality discussions to increase member care, member satisfaction and provider sati ...

  • The Health Plan of West Virginia, Inc.

    Investigative Intake Coordinator

    5 days ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    The SIU Investigative Intake Coordinator (IIC) is part of a team focused on the prevention, detection, investigation, and reporting of healthcare fraud, waste, and abuse (FWA), program integrity initiatives, and the recovery of overpayments in a multi-payer environment. The IIC p ...

  • The Health Plan of West Virginia Inc

    Director, Case Management

    6 days ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionThe Director of Case Management provides leadership, management, oversight, and assessment of all aspects of clinical program management and is responsible for ensuring quality provision of member driven care continuum programs while ensuring deli ...

  • The Health Plan of West Virginia, Inc.

    Supervisor, Delegated Credentialing

    1 week ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    POSITION SUMMARY: · Accountable for delegated credentialing for all markets and products. Ensures delegated credentialing is compliant with the standards established by the National Committee for Quality Assurance (NCQA), WV Bureau of Medical Services, WV Office of Insurance Com ...

  • The Health Plan of West Virginia Inc

    Director, Utilization Management

    6 days ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionThe Director of Utilization Management provides leadership, management, oversight, and assessment of all aspects of management and is responsible for managing overall utilization while ensuring delivery of essential services that address the total ...

  • The Health Plan of West Virginia Inc

    Pension Coordinator

    13 hours ago

    The Health Plan of West Virginia Inc Charleston, United States

    Job Description · Job DescriptionTo assist with administration of the UMWA 1985 Construction Workers Pension Plan and the 1978 Retired Construction Workers Benefit Trust. · Required: · High School graduate or equivalent work experience. · Strong organization skills, verbal and wr ...

  • The Health Plan of West Virginia Inc

    Supervisor, Medicare Sales

    13 hours ago

    The Health Plan of West Virginia Inc Massillon, United States

    Job Description · Job DescriptionThe Supervisor, Medicare Sales reports to the Manager, Medicare Sales and collaborates closely with them as well as other areas and partners to achieve sales growth in the Medicare product line. This includes supervising an internal sales team to ...

  • The Health Plan of West Virginia Inc

    Employer Service Rep

    13 hours ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionThe Employer Service Representative is responsible for answering telephone calls from client contacts in a prompt and courteous manner, resolving any client issues relating to claims and eligibility, and responding to written inquiries from client ...

  • The Health Plan of West Virginia Inc

    Nurse Navigator

    13 hours ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionResponsible to conduct systematic admission, concurrent and retrospective hospital reviews for severity of illness and length of stay, implements discharge planning, and to manage an inpatient authorization with required data and pertinent clinica ...

  • The Health Plan of West Virginia Inc

    Manager, Medical Records

    13 hours ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionUnder the Direction of the Director, Quality Improvement, the Manager, Medical Records is responsible for overseeing the day to day operations of maintaining, requesting and submitting accurate medical records and member requested information whil ...

  • The Health Plan of West Virginia, Inc.

    Vice President Pharmacy Services

    1 week ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    POSITION SUMMARY: · Responsible for providing the company strategic pharmacy services leadership and direction. Leads the diverse pharmacy service's teams who are responsible for managing the pharmacy benefit for The Health Plan and its clients. This position will lead and devel ...

  • The Health Plan of West Virginia, Inc.

    Director, Utilization Management

    1 week ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    The Director of Utilization Management provides leadership, management, oversight, and assessment of all aspects of management and is responsible for managing overall utilization while ensuring delivery of essential services that address the total health care needs of The Health ...

  • The Health Plan of West Virginia Inc

    Member Advocate

    13 hours ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionUnder the general direction of the D-SNP Unit Manager or Unit Supervisor, the D-SNP Member Advocate is responsible for coordinating administrative functions within the D-SNP Program which may include administering the Health Risk Assessments, sche ...

  • The Health Plan of West Virginia Inc

    Director, Case Management

    2 weeks ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job Description · The Director of Case Management provides leadership, management, oversight, and assessment of all aspects of clinical program management and is responsible for ensuring quality provision of member driven care continuum programs while ensuring ...

  • The Health Plan of West Virginia, Inc.

    Pension Coordinator

    1 week ago

    The Health Plan of West Virginia, Inc. Charleston, United States

    To assist with administration of the UMWA 1985 Construction Workers Pension Plan and the 1978 Retired Construction Workers Benefit Trust. · Required: · High School graduate or equivalent work experience. · Strong organization skills, verbal and written communications. · Excel ...

  • The Health Plan of West Virginia, Inc.

    Risk Adjustment Analyst

    1 week ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    Under the direction of the Manager Risk Adjustment, will support The Health Plan's risk adjustment and coding management goals with regard to the risk adjustment models. The position will be involved in developing, coordinating, and analyzing the impact of various activities used ...

  • The Health Plan of West Virginia, Inc.

    Director, Case Management

    21 hours ago

    The Health Plan of West Virginia, Inc. Wheeling, United States

    The Director of Case Management provides leadership, management, oversight, and assessment of all aspects of clinical program management and is responsible for ensuring quality provision of member driven care continuum programs while ensuring delivery of essential services that a ...

  • The Health Plan of West Virginia Inc

    Compliance Support Coordinator

    5 days ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionThe Compliance Support Coordinator is expected to provide the Compliance Manager and Government Compliance Officer with administrative and organizational support. The Compliance Support Coordinator is expected to complete tasks as assigned and per ...

  • The Health Plan of West Virginia Inc

    Accounting Clerk

    13 hours ago

    The Health Plan of West Virginia Inc Wheeling, United States

    Job Description · Job DescriptionThe Accounts Receivable Representative's primary responsibility is producing accurate billings statements, maintaining accurate accounts receivable records, and assuring controlled and timely collections and documentation. · Required: · High schoo ...