• Director , HMO Claims Services

    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
    Scripps Health (11/14/24)
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  • Claims Complex Director

    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
    AIG (01/07/25)
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  • Director , Claims Recovery Unit

    Banner Health (AZ)
    …innovative employment options by offering remote and hybrid work settings. As a Director , Claims Recovery Unit, you will lead a small team and support three ... vendors. You will primarily monitor Banner Plans & Networks claims payments for accuracy, actively identify deficiencies of incorrect...a daily basis. Your work location will be entirely remote and will require quarterly onsite meetings in Phoenix… more
    Banner Health (12/18/24)
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  • Casualty Claims Manager - Remote

    GuideOne Insurance (Chicago, IL)
    …etc.), submits monthly reports detailing unit activity and results to line of business director and senior claims management as requested. + Responsible for ... As the Casualty Claims Manager, you will be responsible for independently...this is a work from home position leading a remote team. Accountabilities: + Provides direction to claim adjusters… more
    GuideOne Insurance (01/04/25)
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  • Commercial Casualty Claims Adjuster…

    GuideOne Insurance (Dallas, TX)
    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 ... you. Accountabilities: + This position handles Commercial General Liability, Director 's & Officer Liability, Employment Practices Liability, Commercial Auto… more
    GuideOne Insurance (01/04/25)
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  • Director , Claims Management-Virtual

    Alight (SC)
    …claim operations. **Responsibilities** + Leading LOA, STD, ADA, and/or LTD claims service teams. It may also involve leading rehabilitation/clinical teams or ... to integrate products on various platforms. Developing and recommended Claims and Service level strategies and tactics. + Demonstrating...in the flexible workspace and "Top 100 Company for Remote Jobs" 5 years in a row. **Benefits** We… more
    Alight (12/05/24)
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  • Medical Director -- Claims

    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
    Humana (10/29/24)
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  • Claims Litigation Analyst

    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
    AON (10/25/24)
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  • Director , Medical Affairs - NYC…

    Merck (Columbus, OH)
    **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support, and… more
    Merck (12/19/24)
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  • Legal Claims Professional - Public D&O

    Zurich NA (Parsippany, NJ)
    …public company Director 's and Officer's (D&O), Fiduciary and transactional risk claims of moderate to high value and complexity. The ideal candidate will have ... Legal Claims Professional - Public D&O 119736 At Zurich...AM - Addison, AM - Atlanta, AM - Parsippany Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered:… more
    Zurich NA (12/21/24)
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  • Healthcare Medical Claims Coding Sr.…

    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
    Commonwealth Care Alliance (11/26/24)
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  • Associate Director , Product Manger, Data…

    BD (Becton, Dickinson and Company) (Raleigh, NC)
    **Job Description Summary** As Associate Director , Product Management Data & Interoperability, you will lead the Parata Platform data and interoperability global ... enable clinical, operational and financial improvements. Reporting directly to the Director , Central Fill this experienced, results-driven Associate Director more
    BD (Becton, Dickinson and Company) (01/05/25)
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  • Managing Director - Insurance Advisory…

    EPAM Systems (Conshohocken, PA)
    **This Remote Position Cannot be Performed in New York City.** You are a natural leader and a proven operator at the most senior levels of clients in the insurance ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
    EPAM Systems (12/18/24)
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  • Director Account Management, PACE…

    Prime Therapeutics (Columbus, OH)
    …It fuels our passion and drives every decision we make. **Job Posting Title** Director Account Management, PACE - Remote **Job Description** + Owns overall ... Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis… more
    Prime Therapeutics (12/19/24)
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  • Associate Director , Global Labeling Lead…

    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
    Takeda Pharmaceuticals (10/16/24)
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  • Director , Health Plan Analytics…

    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
    Two95 International Inc. (12/10/24)
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  • Associate Director , Epidemiology…

    AbbVie (Chicago, IL)
    …(https://www.instagram.com/abbvieireland/) , YouTube and LinkedIn. Job Description The Associate Director (AD) of Epidemiology in Pharmacovigilance & Patient Safety ... plan development, and execution using various data sources, such as administrative claims and health records data. 2. Conduct comprehensive literature reviews to… more
    AbbVie (12/18/24)
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  • Director , Actuarial Services (Reserve)-…

    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
    UPMC (12/18/24)
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  • Director , Reporting & Analytics (Care…

    Molina Healthcare (Columbus, OH)
    …and other end users for operational and strategic analysis. **Knowledge/Skills/Abilities** The Director of Reporting & Analytics is a key leader within the ... BI_** + **_Clinic Systems experience - CCA_** + **_Experience with CM, UM, Claims , or Authorizations_** To all current Molina employees: If you are interested in… more
    Molina Healthcare (12/12/24)
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  • Dental Director ( Remote )

    CareFirst (Baltimore, MD)
    …quality improvement, disease management, utilization review, and dental/medical claims review, network recruitment, credentialing, provider directory information and ... (all benefits/incentives are subject to eligibility requirements). **Department** Dental Director **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an… more
    CareFirst (12/24/24)
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