- Sedgwick (San Francisco, CA)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Claims Director - Dedicated ( REMOTE ) **PRIMARY PURPOSE** : To be responsible ... Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service requirements. +… 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...We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each… 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 ... how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to complex clinical… more
- EPAM Systems (Philadelphia, PA)
- …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
- Zelis (Morristown, NJ)
- Position Overview: The Director of Out of Network Services is responsible for overseeing the operations and performance of the Out of Network Post Pay Solutions ... department. The Director ensures that the department meets the quality, productivity,...procedures, and contractual obligations related to out of network claims . + Collaborate with other departments, such as network… more
- Humana (Columbus, OH)
- …help us put health first** Humana Healthy Horizons is seeking an Associate Director , Medicaid Provider Services to serve in a strategic leadership role within ... Medicaid segment. The Medicaid Provider Services team, led by the Associate Director , is accountable for Humana's Medicaid segment strategy and operationalizing the… more
- AON (Bloomington, MN)
- …benefits is governed by the applicable plan documents and policies. #LI-RW1 #LI- Remote 2545117 Client Service Reinsurance Associate Director Client Advocate ... Client Service Reinsurance Associate Director Client Advocate Opportunity at Aon! This role...in ceded reserves each year. With the assistance of dedicated mentors you will build and implement your individual… more
- Elevance Health (Chicago, IL)
- ** Director II, Business Improvement** **Location:** This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of ... one of our Elevance Health PulsePoint locations. The ** Director II, Business Improvement** will be responsible for leading...+ Applies knowledge and expertise in Stars, risk adjustment, claims payment, and payment integrity to guide or enhance… more
- Bristol Myers Squibb (Madison, NJ)
- …lives. Read more: careers.bms.com/working-with-us . **Position:** Associate Director , Medical Promotional Review Scientist, Neuropsychiatry **Location:** Princeton ... Pike, NJ or Madison, NJ The Associate Director , Medical Promotional Review Scientist plays a critical role...+ Determine acceptability of data/references used to support promotional claims and provide expert guidance as well as effective… more
- Alight (New York, NY)
- …Be Alight. Learn more at careers.alight.com. **About the Role** As the Program Director , you will oversee a team delivering disability and leave management services. ... excellence and client satisfaction, and nurturing internal colleague engagement. This role is remote with regular travel to the client office in Jersey City, New… more
- Equitable (Charlotte, NC)
- Director of Dental Product Management ( 240000KC ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES- Remote **Organization** ... an organization that will help unlock your potential? Equitable is looking for a Director of Group Dental Product Management to join our Employee Benefits team. This… more
- Humana (Columbus, OH)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Kepro (Albany, NY)
- …outcomes - making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. Acentra ... is looking for a Program Director to join our growing team. Job Summary: As...and processes and with client expectations. *This position is Hybrid/ Remote based in Albany, NY Job Responsibilities: + Direct,… more
- Elevance Health (Columbus, OH)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... business system integrations. **Location:** This position will work in a hybrid model ( remote and office) with once a week from the nearest Elevance Health… more
- Elevance Health (Tampa, FL)
- ** Director II Medicaid State Operations** Location: This position will work a hybrid model ( remote and office). The Ideal candidate will live within 50 miles of ... one of our Elevance Health PulsePoint locations. The ** Director II Medicaid State Operations** is responsible for fiscal and operational management of Health Plan… more
- Elevance Health (Tampa, FL)
- **Provider Collaboration Director - Cost of Care** **Location:** This position will work a hybrid model ( remote and office). Must reside within 50 miles/1 hour ... of our Miami or Tampa, FL Elevance Health location. The **Provider Collaboration Director -Cost of Care** is responsible for local management of all network cost of… more
- Elevance Health (Miami, FL)
- **Provider Collaboration Director -Value Based Care** **Location:** This position will work a hybrid model ( remote and office). Must reside within 50 miles/1 hour ... our Miami or Tampa, FL Elevance Health location. The **Provider Collaboration Director -Value Based Care** is responsible for local management of Enhanced Personal… more
- ASRC Industrial Services (Chattanooga, TN)
- …the United States. **GENERAL POSITION SUMMARY** The Health & Safety Director will provide experience and expertise in the implementation, execution, supervision, ... of the Safety Program and Environmental Protection Program. The Health & Safety Director is to ensure all OSHA, federal, state, local and project specifications are… more
- Zelis (St. Petersburg, FL)
- …delivering on most important tasks (MITs). This role reports into the Sr. Director , Product - Payments Optimization. Responsibilities: + As a Director , ... industry is a plus, including detailed understanding of healthcare claims and enrollment data and how it translates to...FL, and Hyderabad, India. We foster a hybrid and remote friendly culture and all of our employee's work… more
- Zelis (Boston, MA)
- Director , Partnership Marketing Zelis is a healthcare and financial technology company whose purpose is to improve the healthcare financial experience for all. Zelis ... that address the entire financial journey, helping to price and pay healthcare claims and empower consumers to make care decisions. Through its three business units,… more