
51 - 200 employees
🏥 Healthcare
💼 Consulting
🛡️ Insurance
Healthcare • Consulting • Insurance
Peak Health is a health insurer and health insurance services company headquartered in Morgantown, West Virginia. It is owned by three not-for-profit health care providers: WVU Health System, Marshall Health Network, and Valley Health. Peak Health aims to improve community health outcomes by offering an inclusive, provider-led health plan for residents of West Virginia and surrounding areas. The company is committed to making health care more accessible, understandable, and collaborative, with a focus on reducing costs and administrative fees for patients and employers. Peak Health also offers Medicare Advantage coverage tailored for West Virginia seniors through partnerships with leading health systems.
Selected: 🇺🇸 United States – Remote USA.
Selected: 🆕 Date Added.
🕒 3 days ago
Managed care pharmacist overseeing PBM operations, formulary strategy, and clinical quality programs. Optimizing pharmacy outcomes and spend for Peak Health’s health plan clients.
🕒 August 25
ACA Production Lead overseeing Affordable Care Act marketplace production, sales strategies, agent recruitment, and compliance. Supporting Peak Health’s agents and agencies across West Virginia.
🕒 August 14
Network Service Consultant developing provider relationships and educating stakeholders for Peak Health’s health insurance plans. Supporting credentialing, contracting, regulatory reporting, and network strategy.
🕒 July 11
SNP Social Worker assisting in coordination of benefits with MA and Medicaid. Integral member of the health plan’s medical management team attending to community resources and member health needs.
🕒 July 3
Clinical Appeals Coordinator processing medical-necessity appeals for Peak Health’s health plan. Reviewing clinical records, meeting regulatory timeframes, and preparing member and provider responses.
🕒 July 2
Clinical Utilization Management Pharmacist performing drug utilization reviews and collaborating with pharmacy teams to ensure compliance and improvements. Requires pharmacy license and experience in clinical and managed care settings.