- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional...is an exciting time to join us - across our operations , we are thinking in new and innovative ways to ... (HPL) Join us as a Claims Complex Director to take on key responsibilities within a world-class...an impact + This position will ensure high quality claims handling within the Healthcare Professional Liability… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …our Healthsource blog: https://healthsource.premera.com . We are seeking an experienced and dynamic ** Claims Operations Director ** to join our team and ... role in enhancing the quality and efficiency of our claims processes. In this capacity, you will lead a...strategic direction, business planning, and overall leadership for Premera's healthcare payer operations across various customer segments… more
- Banner Health (Phoenix, AZ)
- … Claims Mgmt **Work Shift:** Day **Job Category:** Legal The **Executive Director , Claims & Litigation Counsel** will provide strategic and operational ... with healthcare risk management, quality management, in house liability claims management (including litigation and claims reserves) and litigation**… more
- Zelis (NJ)
- …claims processing. + 5+ years of experience managing a team of 20+ within Claims Operations . + Proven expertise in processing and negotiating all Out of ... Position Overview: The Director of Out of Network Claims ...Claims Negotiations is responsible for overseeing the daily operations of the Out of Network Negotiation department. This… more
- Commonwealth Care Alliance (Boston, MA)
- …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...on financial ability and forecasting for small to large Operations Management + Collaborate system and data configuration into… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- …+ Investigate patient complaints, potential adverse events, and reported medical malpractice claims in collaboration with peers in operations , quality, and ... Summary The Risk Director assesses, plans, implements, and directs the Risk...event. + Design, implement, and maintain organizational systems for claims management and occurrence reporting with the goal of… more
- Sharp HealthCare (San Diego, CA)
- …and employer business practices. **What You Will Do** This Senior Medical Director position provides critical management and oversight for Sharp Health Plan's (SHP) ... practice of medicine. + 5 years' experience as an HMO Health Plan Medical Director . + California Physicians and Surgeons License - Medical Board of CA -REQUIRED… more
- Huron Consulting Group (Chicago, IL)
- …you'll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations , improve clinical outcomes, ... and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling… more
- CommonSpirit Health (Houston, TX)
- …TX office and will travel regionally in the south region. The Region Director Risk Management and Loss Prevention is responsible for orchestrating the successful ... activities within a designated Region in collaboration with Claim Operations , Regional leadership, and market/local risk management professionals. Within an… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …Wellness incentives Ongoing mentorship, development, leadership programs and more! **Description** ** Director , Compliance and Privacy Operations reports to the ... Emory Healthcare Compliance Program oversight with ownership over day-to-day operations . + Responds to requests for guidance from operating units, departments,… more
- UNC Health Care (Morrisville, NC)
- …with excellent communication and interpersonal skills to become the department's first Director of Operations . This position will work closely with department ... tools and information to users of legal, risk management, and audit services. The Director of Operations will report directly to the Chief Legal Officer and… more
- Ascendis Pharma (Princeton, NJ)
- …and develop their skills. Ascendis Pharma is looking to hire an experienced Director , Contract Operations to join our team. Responsibilities will include ... tactical, demonstrating strong leadership, project management, and communication skills. As the Director , Contracting Operations , you will oversee all aspects of… more
- LogixHealth (Bedford, MA)
- Location: On-Site in Bedford, MA This Role: As a Director of EDI at LogixHealth, you will work with internal teams to provide cutting edge solutions that will ... directly improve the healthcare industry. Specifically, this position manages employees who handle...oversee and monitor all functions of the EDI team operations + Initialize new client EDI set up process… more
- Providence (Burbank, CA)
- …wide range of settings + Must possess skills and understanding of hospital clinical healthcare operations and quality data management + Quality and Safety + ... **Description** **THE ROLE** Under the direction of Executive Director of Quality provides day to day operational...programs designed to reduce incidence and magnitude of damage claims made against the hospital and to maintain regulatory… more
- Texas Health Resources (Arlington, TX)
- **Program Director , Compliance Operations and Project Management - Hybrid** This role is hybrid, remote and in office at Texas Health Resources Corporate Offices ... life's best work here! **What you'll do** The successful candidate for **Program Director for Compliance Operations and Project Management** will be responsible… more
- Healthfirst (NY)
- …guidelines that impact Contact Center Operations , Enrollment and Billing and Claims operations for Medicaid, Medicare, and Commercial lines of business (ie ... **Duties/Responsibilities:** Design and execute the operations internal audit strategy to assess financial, operational, and compliance risks Lead a team responsible… more
- CVS Health (Frankfort, KY)
- …make health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by ... and claims data. **Preferred Qualifications** + Experience as a healthcare clinical consultant is highly desirable. + Specific experience within value-based… more
- Olympus Corporation of the Americas (Center Valley, PA)
- …other than @Olympus.com, it is likely not legitimate._ **Job Description** The Director Scientific Communications, Global Operations plays a central role in ... with regulatory requirements. **Job Duties** + Leads the Scientific Communication Operations team. + Develop, drive, and maintain the process and technology… 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,...processes and systems. Key Responsibilities: + Manage the day-to-day operations of the out of network post pay department,… more
- Fallon Health (Springfield, MA)
- …the Site Director . Oversees the timely and accurate processing of claims , data collection and reporting including those related to the Electronic Medical Record ... as Needed:** + Provides oversight of day-to-day PACE center operations in collaboration with SE Site Director ...PACE site. + Oversees the timely processing of all claims and invoices and referrals, ensuring all external appointments… more
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