- 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
- Elevance Health (Denver, CO)
- **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model ( remote and office). Ideal ... live within 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for collaborating with… more
- Zelis (NJ)
- Position Overview: The Director of Out of Network Claims Negotiations is responsible for overseeing the daily operations of the Out of Network Negotiation ... historical equivalent experience. + 10+ years of experience in claims processing. + 5+ years of experience managing a...FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work… 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
- Providence (NM)
- …to improve efficiency of department work; and to assist the Group Vice President and Director of Risk & Claims as needed **Provide Input to Reduce Risk** + ... through the Risk & Integrity Services division and Risk, Claims , & Insurance department **Providence welcomes 100% remote... Claims , & Insurance department **Providence welcomes 100% remote work for applicants who reside in one of… 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
- Zurich NA (Columbus, OH)
- …Office, AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR ... Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our… more
- Commonwealth Care Alliance (Boston, MA)
- …is Important to Us:** **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 (Sacramento, CA)
- …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
- 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
- AbbVie (Chicago, IL)
- …on Twitter, Facebook, Instagram, YouTube and LinkedIn. Job Description The Director (Epidemiology) is a member of the Global Epidemiology in Pharmacovigilance ... development of capabilities/methodology to bridge knowledge gaps. The Epidemiology Director provides expertise in regulatory pharmacoedemiology across functions. The… 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
- Select Medical (Camp Hill, PA)
- …This position will also be involved in special projects as assigned by the Director of CBO or VP Patient Accounting. **Responsibilities** + Trains new IP CBO team ... both technical and functional on-the-job training for on-site and remote team members. + Creates and keeps up-to-date all...members. + Any additional projects as assigned by the Director of CBO or VP Patient Accounting + Training… 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
- State of Indiana (Indianapolis, IN)
- Claims Payment Officer Date Posted: Oct 30, 2024 Requisition ID: 449968 Location: Indianapolis, IN, US, 46219 Work for Indiana Begin a fulfilling career with the ... through the Social Security Administration's "Ticket to Work" program. Role Overview: The Claims Payment Officer (CPO) is a position within the Family and Social… 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