- Trustmark (Columbus, OH)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Scripps Health (San Diego, CA)
- …quarter of our employees have been with Scripps Health for over 10 years. The Director of HMO Payment ( Claims ) Services for Scripps Health Plan, leads claims ... * Mailroom experience. **Job:** **Finance* **Organization:** **Scripps Health Corp* **Title:** * Director , HMO Claims Services* **Location:** *Central San Diego… more
- AIG (Lenexa, KS)
- Claims Complex Director Join us as a Claims Complex Director to take on key responsibilities within a world-class claims function. Make your mark in ... Claims Our Claims teams are the proven problem solvers of choice...career path. + Potential for flexible work arrangement, including remote working. + Candidates residing outside the Atlanta metropolitan… more
- Providence (Renton, WA)
- …Federal, State, health plan and contractual regulations and guidelines. The Executive Director Claims Operations interfaces with internal and external resources ... **Description** **THE ROLE** The Executive Director directs, manages and oversees the activities of...management of pre-suit and litigated large loss and severity claims , including early and thorough assessment of issues, proper… more
- Martin's Point Health Care (Portland, ME)
- …2015. Position Summary Job Description Position Summary: Under the supervision of the Director of Health Plan Operations, the Claims Auditor II will perform ... Martin's Point, either verbally or through written communications, regarding questions related to claims , claims audits or other matters directed to the Audit… more
- Humana (Columbus, OH)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… more
- AON (Fort Wayne, IN)
- …look like As a Claims Litigation Analyst, you will report directly to the Claims Manager and/or Claims Director working in the challenging and rewarding ... by the applicable plan documents and policies. #LI-CC1 #LI-HYBRID #LI- REMOTE 2551890 Claims Litigation Analyst K&K Insurance... Litigation Analyst, you will report directly to the Claims Manager and/or Claims Director … more
- Commonwealth Care Alliance (Boston, MA)
- 011250 CCA- Claims **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... Coding Sr. Analyst will be responsible for developing prospective claims auditing and clinical coding and reimbursement edits and necessary coding configuration… more
- Centene Corporation (New York, NY)
- …perspective on workplace flexibility. **Position Purpose:** Assist the Chief Medical Director to direct and coordinate the medical management, quality improvement ... of performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals and policies to improve quality… more
- Sedgwick (Miami, FL)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Client Services ( REMOTE ) **PRIMARY PURPOSE** : To determine ... rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability to… more
- AbbVie (Chicago, IL)
- …LinkedIn. Job Description *Position can sit remotely anywhere in the US The Director , Patient Centered Outcomes Research, is responsible for the design and execution ... functions (eg, Clinical Development & Operations, Regulatory, Commercial). The Director , Patient-Centered Outcomes Research, will support a therapeutic area and… more
- Takeda Pharmaceuticals (Columbus, OH)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- Two95 International Inc. (Atlanta, GA)
- Job Title: Director , Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As ... the Director of Analytics, you will lead a team of...including but not limited to enrollment, finance, call center, claims , Case Management and Utilization Management * 5+ years… more
- UPMC (Pittsburgh, PA)
- …a place for you. UPMC Health Plan's growing Actuary department is seeking a Director , Actuary to ensure that the UPMC Health Plan Actuarial Department provides the ... the financial reporting department to develop reserve amounts for IBNR claims , active claims and premium deficiency reserves on a regular or as-needed basis.… more
- EPAM Systems (Boston, MA)
- …be the perfect opportunity for you to join EPAM as a **Managing Director , Insurance Advisory** . Scroll down to learn more about the position's responsibilities ... operational capabilities **Requirements** + Prior experience as a Managing Director (Partner, or equivalent level) with primary client relationship responsibility… more
- Crawford & Company (Phoenix, AZ)
- …claim adjusters and other staff and oversee the analysis, review and validation of claims under the direction of the Managing Director . Ensures processes and ... is an IN-OFFICE postion that will not convert to remote . Must be local to Phoenix AZ. Responsibilities +...years of experience as an Adjuster, Adjuster in Charge, Claims Supervisor or Claims Manager. + Previous… more
- RTX Corporation (Tallahassee, FL)
- Date Posted: 2024-10-30 Country: United States of America Location: RFL99: RTN Remote , Florida Position Role Type: Remote RTX Corporation is an Aerospace and ... compliance to RTX and BU policies & FAR / DFAR requirements. + Validate claims that design requests are necessary because of contract compliance + Participate in… more
- CareFirst (Baltimore, MD)
- …experience. **Experience:** + 8 years experience in health insurance, call center, claims and/or enrollment and billing environment. + 3 years experience in ... managerial functions in a customer service, claims and/or enrollment and billing or related field. **Preferred Qualifications:** + 2-3 years experience working with… more
- IQVIA (Durham, NC)
- …capabilities to a health plan: data & analytics, interoperability, claims processing, population health.** + Exemplary interpersonal, relationship building, ... negotiations, and professional skills. + Confident, assertive, results driven, strong organizational skills and self-motivated, self-starter. + Must be self-motivated, have the internal drive to keep calling even when not getting traction immediately and have… more
- Michigan State University (East Lansing, MI)
- …Financial/Accounting, Executive Management, Full Time (90-100%), Non-Union, Remote -Friendly Working/Functional Title Executive Director , Risk ... Job postings Executive Mgtmt Director -Exec Mgt Back to search results Apply now...management support organizations and community members. This position is " remote -friendly," with the expectation of an on-campus presence on… more