- CVS Health (Columbus, OH)
- …Three (3) years or more of health plan/payor experience. Licenses: * Medical Director Board Certification is required * Active and current state medical ... each and every day. **Position Summary** This Executive Medical Director - Medical Policy & Operations leads a team...train, and retain Medical Directors Deep knowledge of Clinical Claim Review policy, procedure, and workflows. **Education** MD or… more
- City and County of San Francisco (San Francisco, CA)
- …issues related to medical clinic operations. 14. Provides ongoing system support to claims staff. 15. Accurately estimates the potential claim costs (reserves) ... be of 6 months, and may be extended with the approval of the Human Resources Director . Certification - The certification rule for the eligible list resulting… more
- Humana (Raleigh, NC)
- …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...>65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current… more
- Alight (NJ)
- …you a successful leader who is experienced in leading a team of claims professionals? Seeking an experienced team leader skilled in delivering subject matter ... and leading a team of leave and disability managers with varying degrees of claim handling skills. This role will leverage expertise to navigate complex claim … more
- Humana (Juneau, AK)
- …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...>65 years of age). + Current and ongoing Board Certification an approved ABMS Medical Specialty + A current… more
- UNC Health Care (Chapel Hill, NC)
- …health and well-being of the unique communities we serve. **Summary** : Reporting to the Director of Claims & Litigation, the Claims and Litigation Manager ... interviews with relevant staff and analysis of value of claim . Assists the Director in managing external...claims information in the internal database. Assists the Director in other projects related to claims … more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** Under the direction of the Director , Claims & Litigation Strategy, the Claims Manager oversees the ... procedures and the applicable service agreement. Review reserves, settlement activity, and claims costs. Participate in periodic claim reviews and provide… more
- GuideOne Insurance (Lincoln, NE)
- As a Commercial Casualty Claims Adjuster, you will serve as a real partner to our members by processing claims accurately and efficiently so they can resume ... + This position handles Commercial General Liability, Commercial Trucking, Director 's & Officer Liability, Employment Practices Liability, Commercial Auto injuries,… more
- Commonwealth Care Alliance (Boston, MA)
- …at this time._** **Position Summary:** Working under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims ... to have the one or all of the required certification OR willing to get certified within 1 year...claims management, coding rules and guidelines, and evaluating/analyzing claim outcome results for accurate industry standard coding logic… more
- BronxCare Health System (Bronx, NY)
- …needed. - Participates in special projects and committees as determined by Director . Qualifications CERTIFICATION /LICENSURE : Registered Nurse or physician or a ... collection, analysis, implementation of and compliance with risk management and claims activities, support of and participation in Continuous Quality Improvement… more
- Medtronic (Los Angeles, CA)
- …connected, compassionate world. **A Day in the Life** The Principal Insurance and Claims Management role is a newly created expert and highly specialized position ... under Medtronic Diabetes Risk Management, reporting directly to the Sr. Director , Insurance and Risk Management. This position plays a key role in the Insurance… more
- Fluor (Fresno, CA)
- …Central Valley. Under the general direction of the Director and Deputy Director of the PMO/forensics & Claims , this role is responsible for developing ... also responsible for reviewing and analyzing Contractors' Time Impact Analyses and claims and assisting with the rebuttal responses. In addition to forensic analysis… more
- Saint Francis Health System (Tulsa, OK)
- …remittance processing using Epic Resolute Hospital Billing/Professional Billing (HB/PB) and associated claims tools (eg, Claim Edit Work Queues (WQs), Remittance ... **to login and apply.** Full Time Job Summary: The Director , Revenue Cycle-Patient Accounting is responsible for directing and coordinating… more
- Commonwealth of Pennsylvania (PA)
- Assistant Deputy Director (Administrative Officer 4) Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5170354) Apply Assistant Deputy ... Director (Administrative Officer 4) Salary $77,379.00 - $117,497.00 Annually...attach a copy of your college transcripts for your claim to be accepted toward meeting the minimum requirements.… more
- Iowa Department of Administrative Services (Des Moines, IA)
- Administrative Assistant to Medicaid Deputy Director of Policy and Planning Print (https://www.governmentjobs.com/careers/iowa/jobs/newprint/5165958) Apply ... Administrative Assistant to Medicaid Deputy Director of Policy and Planning Salary $49,400.00 - $72,612.80 Annually Location Des Moines - 50319 - Polk County, IA Job… more
- Polk County Public Schools (Bartow, FL)
- **Position Title:** Director , Risk Management **FLSA Status:** Exempt **Salary Grade, if non-union:** SG21 **Pay Grade, if union:** **Non-Union or Specific ... in administering the various insurance plans. Develops and supervises loss and claim processing procedures for all types of losses, accidents, and injuries. Reviews… more
- Mount Sinai Health System (New York, NY)
- **Job Description** ** Director of RCM EPIC Optimization Patient Financial Services -Corporate 42** **nd** **Street- Full-Time-Days (Hybrid)** The Director of ... in financial performance, operational efficiency, and patient experience. The Director will collaborate closely with operational, clinical, and IT stakeholders… more
- The County of Los Angeles (Los Angeles, CA)
- DIRECTOR , DISTRICT ENVIRONMENTAL SERVICES Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4809278) Apply DIRECTOR , DISTRICT ENVIRONMENTAL ... various health districts/regions throughout the County. This position reports to the director of environmental health services in the Department of Public Health.… more
- Westminster Management (Florham Park, NJ)
- …best in class. Be Solution-Oriented. Be Accountable. Be caring. JOB SUMMARY The Director of Risk Management is responsible for designing and executing an integrated ... strategies, and facilitating solutions to risk related issues. RESPONSIBILITIES The Director of Risk Management receives general guidance and direction from the… more
- University of Washington (Seattle, WA)
- …and Vice Chairs, as well as the Executive Director of UW Risk Management, the Director of UW Claims Services and UW Claims Managers + Participate in the ... **UW Medicine has an outstanding opportunity for a Communication and Resolution Program (CRP) Director .** The CRP Director ( Director ) plays a critical role… more