• Senior Strategy Analyst

    Highmark Health (Pittsburgh, PA)
    …in business, Economics, Engineering or Life Sciences or related field + Experience in Health Insurance operations and technology + Experience in operational ... In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
    Highmark Health (11/02/24)
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  • Director Solution Portfolio-Product Management,…

    Highmark Health (Columbus, OH)
    …To Include: + 3 years in Business or Healthcare **Preferred** + 5 years with Health Insurance and/or Provider operations + 3 years with operational ... all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the… more
    Highmark Health (01/03/25)
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  • Ops-UM Training Specialist

    Integra Partners (Troy, MI)
    …SKILLS: + Certification in Utilization Review or Case Management + Experience with health insurance operations and claims processing + Familiarity with ... training methods, tools, and techniques. + Experience training for call center or Operations areas in the health care industry preferred. + Adequate knowledge… more
    Integra Partners (01/07/25)
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  • Manager Solution Portfolio

    Highmark Health (Columbus, OH)
    …+ 3 years in a management or leadership role **Preferred** + 3 years in Health Insurance and/or provider operations + 3 years in Product Management ... all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the… more
    Highmark Health (11/25/24)
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  • Director Integrated Experience Design

    Highmark Health (Columbus, OH)
    …years applying design process within Agile technology/R&D environments **OR** + 3 years with Health Insurance and/or Provider operations **OR** + 3 years ... all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the… more
    Highmark Health (01/22/25)
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  • Senior Manager (Audit)

    Manulife (Boston, MA)
    …Minimum 2 years of life insurance experience, strong understanding of life and health insurance operations and products is required. + Good understanding ... of life and health insurance operations , applicable regulations, and risks. + Knowledge of SOX/MAR, Corporate Pricing and Valuation Standards, and financial… more
    Manulife (01/15/25)
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  • Care Navigator

    Medical Mutual of Ohio (OH)
    …interviewing techniques** + **Knowledge of medical terminology** + **Basic knowledge of health insurance operations .** Medical Mutual is looking to ... Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million… more
    Medical Mutual of Ohio (01/04/25)
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  • Compliance Program Manager III

    Point32Health (Canton, MA)
    …**Experience** + Required: 5-8 years of regulatory, compliance and legislative activities, health insurance operations or legal research or equivalent ... **Who We Are** Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our… more
    Point32Health (01/03/25)
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  • Provider Credentialing & Data Records Coordinator

    Medical Mutual of Ohio (Brooklyn, OH)
    …(minimum high school diploma or GED) and experience. + 2 years of experience in health insurance operations or equivalent general office experience in the ... Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million… more
    Medical Mutual of Ohio (01/12/25)
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  • Supervisor, Claims Services

    Medical Mutual of Ohio (Brooklyn, OH)
    …combination of education/training and experience. . 7 years progressive experience in health insurance claims operations , preferably in a leadership ... Mutual is the oldest and one of the largest health insurance companies based in Ohio. We...us and help our members achieve their best possible health and quality of life. Supervises daily operations more
    Medical Mutual of Ohio (01/09/25)
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  • Corporate Accounts Representative - Full time

    Henry Ford Health System (Detroit, MI)
    …within the health care industry + Knowledge of Managed Care, hospital operations , health insurance , or closely related products + Previous experience ... services - from primary and preventative care to complex and specialty care, health insurance , a full suite of home health offerings, virtual care, pharmacy,… more
    Henry Ford Health System (12/12/24)
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  • Senior Corporate Project Manager

    Point32Health (Canton, MA)
    …+ Minimum 3 years' experience in process management + Minimum 3 years' experience in health insurance operations or healthcare setting if PMP certified or 5 ... **Who We Are** Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized...+ Paid time off + Employer-paid life and disability insurance with additional buy-up coverage options + Tuition program… more
    Point32Health (01/03/25)
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  • Senior Finance Technology Implementation…

    Humana (Louisville, KY)
    …within complex environments. + Facilitating cross-functional teams' efforts. **Preferred Qualifications** + Health insurance operations expertise. + 2 or ... **Become a part of our caring community and help us put health first** The Business Informatics Shared Services (BISS) Team is focused on optimizing the execution,… more
    Humana (01/15/25)
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  • Project Manager

    CGI Technologies and Solutions, Inc. (New Brunswick, NJ)
    …(VP, SVP, CXO), Desired skills: * Prior Heath Care Payor business and/or health insurance operations experience desired * Experience with Affordability ... and Well-being programs **Skills:** + Health - Medicaid + Health Care Payers + Health Insurance + PMI Project Management Prof + Project Management… more
    CGI Technologies and Solutions, Inc. (12/21/24)
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  • Clinical Navigator (Hybrid)

    CareFirst (Baltimore, MD)
    …of a health care system, payer organization, health plan and/or health insurance operations (eg networks, eligibility, benefits). + Must be able ... role will function as a liaison onsite at a health system in Maryland with the hospital care team...process and national, evidence based clinical guidelines and hospital operations . + Knowledge of available community resources and programs.… more
    CareFirst (11/22/24)
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  • Senior Database Engineer

    Humana (Columbus, OH)
    …other cloud reporting systems or experience in Cloud design + Experience working with health insurance operations related data to include enrollment, claims, ... **Become a part of our caring community and help us put health first** The Senior Database Engineer leads important projects in design, development, implementation… more
    Humana (01/23/25)
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  • Issuer Operations Analyst - State Based…

    State of Georgia (Fulton County, GA)
    …regulations. Develops corrective action plans for non-compliance of health insurance carrier plans. Maintains policies and operations of the Small ... standards. Manages the annual auto re-enrollment process and forwards related health insurance carrier communications. Confirms completion and accuracy of… more
    State of Georgia (01/08/25)
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  • Regulatory Audit Specialist Sr. - Remote

    Prime Therapeutics (Columbus, OH)
    …in working with the Microsoft Office Suite ​​ **Preferred Qualifications** + Health insurance /PBM operations and/or regulatory compliance audit experience ... to ensure the most effective and efficient processes and operations are put into place to decrease risk for...assigned ​ **Minimum Qualifications** + Bachelor's degree in Business, Health Care Services or related area of study, or… more
    Prime Therapeutics (01/04/25)
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  • VP, Business Insurance Technology…

    Travelers Insurance Company (St. Paul, MN)
    …years of people management experience required. **What Is in It for You?** + ** Health Insurance ** : Employees and their eligible family members - including ... and leading operations that shape the future of our Business Insurance Technology (BI Tech) federated agile organization. You will lead a diverse and… more
    Travelers Insurance Company (01/10/25)
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  • Director of Health Complaints and External…

    New York State Civil Service (Albany, NY)
    …EA and IDR processes, as well as relationships with regulated health insurance companies;* Oversees the daily operations of the Consumer Representative Unit ... Duties include, but are not limited to:* Oversees the daily operations of the Health Unit within CAU, which includes two major consumer protection programs:… more
    New York State Civil Service (12/17/24)
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