- Guardian Life (Charleston, WV)
- As the ** Behavioral Health Clinical Consultant ** resource in disability claims, you will be responsible for reviewing and analyzing a wide range of ... in determining claim liability and ensuring appropriate claim outcomes. The Behavioral Health Clinical Consultant collaborates with treating providers… more
- Highmark Health (Charleston, WV)
- …enrolled in Medicare STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected ... exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for collaborative work with other functions in the… more
- Highmark Health (Charleston, WV)
- …**Job Description :** **JOB SUMMARY** Dynamic and results-oriented Pharmacy Benefit Consultant , serving as the client-facing expert, driving growth and retention of ... Consultation: Provide in-depth pharmacy benefit expertise, offering strategic guidance, clinical recommendations, and solutions tailored to individual client needs.… more
- Elevance Health (Charleston, WV)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... discuss review determinations. + Serves as a resource and consultant to other areas of the company. + May...Leads, develops, directs, and implements clinical and non- clinical activities that impact health care quality… more
- Elevance Health (Charleston, WV)
- …an equivalent background. + For Health Solutions and Carelon organizations (including behavioral health ) only, minimum of 5 years of experience providing ... responsible for the administration of medical services for company health plans and helps ensure clinical integrity...effectiveness and quality. + Serves as a resource and consultant to other areas of the company. + May… more
- Highmark Health (Charleston, WV)
- …a book of business and the business relationship as a strategic consultant for existing accounts directly or through intermediaries. The incumbent is responsible ... accounts to ensure retention and growth of profitable business. **HNAS ( Health Now Administrative Services)** offers flexible, cost-effective solutions for employee … more