The Health Plan Of West Virginia Inc Jobs

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... Read More

Under the direction of the Manager of Claims, the reviewer performs initial review of claims, including HCFA 1500 and UB 04 claims. Reviewer must meet or exceed production... Read More

Under the direction of the Director, Quality Improvement, is responsible for assisting with administering and monitoring plan-wide Quality Improvement Quality Management... Read More

Job Description Job Description The Stop Loss Analyst works with Reinsurance Carriers in filing for reimbursement for groups that have claimants that have gone over the... Read More

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... Read More

Job Description Job Description Responsible to conduct systematic admission, concurrent and retrospective hospital reviews for severity of illness and length of stay,... Read More

Job Description Job Description Under the direct supervision of the Manager of Credentialing, responsible for coordinating all delegated provider credentialing activities... Read More

Job Description Job Description The Accounts Receivable Representative s primary responsibility is producing accurate billings statements, maintaining accurate accounts... Read More

Under the direction of the Director, Implementation Eligibility, Document Specialist is to develop and maintain all Summary Plan Documents (SPD) for all Self Funded... Read More

Job Description Job Description Medical Professional(s) responsible for direction and oversight of healthcare services provided to Plan members to ensure the delivery of... Read More

Job Description Job Description The Behavioral Health Medical Director position at The Health Plan (THP) involves providing clinical guidance to the Behavioral Health Care... Read More

Job Description Job Description THIS IS NOT A REMOTE POSITION Under the direct supervision of the Supervisor, Nurse Analyst, the Quality Medical Record Abstractor will be... Read More

Job Description Job Description The Customer Service Representative is responsible for answering phone calls in a prompt and courteous manner to achieve contractual... Read More

Job Description Job Description The Director of Case Management provides leadership, management, oversight, and assessment of all aspects of clinical program management... Read More

Job Description Job Description The Stop Loss Account Manager is responsible for responding to complex service inquiries, solving non-routine problems using independent... Read More

Job Description Job Description Under the leadership of the Vice President Quality Improvement, the Clinical Quality Stars Program Manager will coordinate the clinical... Read More

Job Description Job Description The Stop Loss Account Manager is responsible for responding to complex service inquiries, solving non-routine problems using independent... Read More

Job Description Job Description The Employer Service Representative is responsible for answering telephone calls from client contacts in a prompt and courteous manner,... Read More

Job Description Job Description Responsible to conduct systematic admission, concurrent, and retrospective hospital reviews for severity of illness and length of stay, to... Read More