- The Cigna Group (Bloomfield, CT)
- The Claims Strategy and Payment Integrity Senior Manager will play an important role in our Affordability strategy by providing claim payment oversight for the ... a minimum of 5 years' experience in ACA Claim Operations and/or Payment Integrity functions, such as claims...programs, visit Life at Cigna Group . **About Cigna Healthcare ** Cigna Healthcare , a division of The… more
- Providence (NM)
- …for services and take proper steps to pay vendors + Inform Senior Manager Operations of large or complex claims and claims with potential for media ... them.** **Providence is calling a Sr. Professional Liability Medical Claims Manager who will:** **Investigate, Evaluate, and...roundtables + Assist in Regional CEO Conferences with Senior Manager Operations + Facilitate and participate in… more
- Elevance Health (Columbus, OH)
- **Staff VP Claims Operations (Original Claims )** **Location:** Successful candidate must reside within 50 miles of an Elevance office, and able to work a ... solutions + Experience having accountability for performance of large-scale claims operations + Experience managing large teams...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… more
- UCLA Health (Los Angeles, CA)
- Description We are seeking a detailed-oriented and experienced Claims Manager to join our Claims leadership team. In this key role, you will oversee a ... work experience, preferred + 5 years previous experience in claims operations specifically related to Medicare Advantage...Advantage or managed care in a complex and diversified healthcare or health insurance company + 3 years experience… more
- The Cigna Group (Denver, CO)
- The Medical Claims FP&A Senior Manager will manage projection and results analysis for core Medicare Advantage Part C medical claims expense processed and ... is expected to be the largest focus for the manager in the medium and long term. This individual...limited to FP&A centralization, Market Finance, Product, Pricing, Reserving, Operations , and external Audit Firms. Given the close partnership… more
- Robert Half Management Resources (Bellaire, TX)
- Description We are offering a long term contract employment opportunity for a Medical Claims Manager in Bellaire, Texas. This role operates within the ... healthcare and social assistance industry and involves managing the claims payment process, specifically focusing on Tapestry report and data processing outside… more
- LA Care Health Plan (Los Angeles, CA)
- …that purpose. Job Summary The Claims Supervisor works with the Claims Manager to oversee the daily operations of the claims department. This position ... Supervisor, Claims Job Category: Claims Department: ...Duties Continued Education Required Bachelor's Degree in Business or Healthcare Related Field In lieu of degree, equivalent education… more
- Guidehouse (San Antonio, TX)
- …in Lieu of Diploma / GED. + 0-2+ year's experience in office, business, operations , customer service or healthcare field. **What Would Be Nice To Have** ... home._** **_Questions regarding this position, you may contact Chris Rivera ( Manager , Talent Acquisition) at ###._** + Representatives are responsible for working… more
- DoorDash (Tempe, AZ)
- …the company's bottom line. The team is divided into three separate subgroups: Actuarial, Claims Operations , and Risk Management & Mitigation. We are looking for ... are required. You will report to the Insurance Claims Manager and work a hybrid schedule...well-being by providing comprehensive benefits and perks including premium healthcare , wellness expense reimbursement, paid parental leave and more.… more
- Catholic Health Services (Melville, NY)
- …are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! Job ... Details Under minimal supervision, formulates and defines Resolute Hospital Billing/ Claims scope and objectives through research and fact-finding to develop or… more
- Guidehouse (El Segundo, CA)
- …experience in lieu of diploma/GED + 0-2+ years relevant experience within healthcare , insurance, business and/or revenue cycle operations . **What Would Be ... from home._** **_Questions regarding this position, you may contact Chris Rivera ( Manager , Talent Acquisition) at ###_** **Essential Job Functions** + Hospital … more
- Guidehouse (Lewisville, TX)
- …in Lieu of Diploma / GED. + 0-2+ year's experience in office, business, operations , customer service or healthcare fields. **What Would Be Nice To Have** ... from home._** **_Questions regarding this position, you may contact Chris Rivera ( Manager , Talent Acquisition) at ###._** The Patient Account Representative has an… more
- Healthfirst (NY)
- …with health plan operations and IT + Experience working as a project manager in a healthcare setting + Experience with adult learning and development ... frameworks and methodologies required by Healthfirst. + Represents Healthfirst Operations in the development of business requirements and associated artifacts… more
- Molina Healthcare (Worcester, MA)
- …leadership and direction to MMS Operational Units management staff (eg, Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care Provider ... Network), for management and supervision of daily functional operations to insure compliance to contract requirements. **Knowledge/Skills/Abilities** * Oversees… more
- Robert Half (Dallas, TX)
- …+ The healthcare industry knowledge and a deep understanding of claims data, payer operations , internal controls, compliance, IT, and/or financial processes ... JOB REQUISITION Finance & Performance Management - Healthcare Industry - Manager LOCATION DALLAS ADDITIONAL LOCATION(S) AUSTIN, CHICAGO, HOUSTON JOB DESCRIPTION… more
- Terumo Medical Corporation (Somerset, NJ)
- Healthcare Compliance Manager Date: Nov 2, 2024 Req ID: 3688 Location: Somerset, NJ, US, 08873 Company: Terumo Americas Holding, Inc. Department: TAH Legal ... wherever we go next!** **_Advancing healthcare with heart_** **Job Summary** Healthcare Compliance Manager supports the Director - Healthcare Compliance… more
- HCA Healthcare (Nashville, TN)
- **Description** **Job Summary and Qualifications** The Coding Operations Education and Appeals Consultant is responsible for assisting in the efficient and effective ... design, development, and delivery of all coding operations education components and an effective coding appeals review...Education Consultant works with the PSG Central Coding Support Manager and team to improve the accuracy, integrity and… more
- Roper St. Francis (Ladson, SC)
- **Thank you for considering a career at** **Roper St. Francis Healthcare !** **Scheduled Weekly Hours:** 40 **Work Shift:** Days (United States of America) ... St. Francis Office Park, Ladson, SC** **Shift: 8:00am-5:00pm** **Job Summary:** The Manager of Managed Care is responsible for implementing and overseeing the daily… more
- Elevance Health (Plano, TX)
- ** Operations Expert** A proud member of the Elevance Health family of companies, Paragon Healthcare brings over 20 years in providing life-saving and life-giving ... within 50 miles of one of our Plano, Texas PulsePoint location. The ** Operations Expert** is responsible for providing technical direction, guidance and resources to… more
- Molina Healthcare (MS)
- …adequacy, financial performance and operational performance, in alignment with Molina Healthcare 's overall mission, core values, and strategic plan and in compliance ... and JOCs. Entail heavy negotiations. Maintains critical Complex provider information on claims and provider databases. Synchronizes data among multiple claims … more
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