Government Jobs in Charleston

Job Information Humana Manager, Utilization Management RN - Remote in Charleston West Virginia Description The Manager, Utilization Management Nursing utilizes clinical nursing skills to support the coordination, documentation and communication of ..

Job Information Humana Medical Coding Auditor - Outpatient & Surgical Specialty Coding Team-Remote in US in Charleston West Virginia Description The Medical Coding Auditor reviews medical claims submitted against medical records ..

Job Information Humana Senior Cloud Services Engineer in Charleston West Virginia Description Responsibilities Are you looking for an innovative way to utilize your cloud engineering skills in hybrid cloud environment and ..

Job Information Centerwell Licensed Practical Nurse Home Health Full Time in Charleston West Virginia As a H ome Health LPN , you will: Provide professional nursing services under the direction of ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Job Information Kindred at Home LPN, Home Health Per Diem in Charleston West Virginia As a Home Health LPN, you will: Provide professional nursing services under the direction of a RN ..

Description The Behavioral Health Medical Director makes determinations regarding prior authorization and retrospective reviews for inpatient and outpatient services to ensure that members receive clinically appropriate and medically necessary services. All ..

Description The Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All ..

Description If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver exceptional ..

Description Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members ..

Description Responsibilities If you are a problem solver, resourceful, and looking to make a difference for your family as well as others we want you on our team. Help us deliver ..

Description The CCM Compliance Professional 2 ensures compliance with governmental and contractual requirements. The CCM Compliance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the ..

Description The DRG Validation Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM and PCS) to patient records. The Medical ..

Job Information Humana Director, Informatics in Charleston West Virginia Description The Director, Informatics coordinates with other analytics, IT and business areas across the organization to ensure work is completed with insights ..

Description The Behavioral Health Market Development Advisor provides support to assigned health plan and/or specialty companies relative to Medicare/Medicaid/TRICARE/Employer Group product implementation, operations, contract compliance, and federal contract application submissions. The ..

Description The Senior Security Professional protects the organization's employees, properties, and all items of value on premises from any preventable harm or danger. The Senior Security Professional work assignments involve moderately ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..

Job Information Humana Bilingual Quality Auditor in Charleston West Virginia Description The Bilingual Quality Auditor/ Professional 2 ensures that products meet specific Centers for Medicaid and Medicare Services standards of quality. ..

Job Information Humana Fraud and Waste Investigator - Work At Home (Anywhere in the US) in Charleston West Virginia Description Humana is looking for an experienced Healthcare Investigator to join its ..

Job Information Humana Senior Fraud and Waste Investigator-- REMOTE/WORK AT HOME in Charleston West Virginia Description Humana is looking for an experienced Senior Healthcare Investigator to join its industry leading Special ..

Description Humana is seeking a Senior Communications and Marketing Professional to join our growing team. The Senior Communications and Marketing Professional will create and lead strategy for Humana's Wisconsin Medicaid Market ..

Description The Lead Behavioral Health Medical Director oversees the work of 2 Medical Directors who conduct clinical case reviews of the care received by members in an assigned market, member population, ..

Description The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing appeals for Medicare Part C Line of Business. The Medical Director provides medical interpretation and determinations ..