- Harbor Health Services, Inc. (Mattapan, MA)
- …those upon request of utilization or finance department. Works with UM RNs and Senior Medical Director to deny claims when appropriate. Attends IDT meetings ... improvement plans, and assess outcomes. Promotes the appropriate use of InterQual's medical management treatment guidelines. Ensures controls are established to… more
- Aveanna Healthcare (Madison, WI)
- ** 20% Incentive Plan ** Position Overview The Area Executive Director (AED) is responsible for the administrative, operational, and leadership oversight of a ... branches and operational leadership. Essential Job Functions The Area Executive Director is responsible for directly managing all essential operational and… more
- University of California Santa Cruz (Santa Cruz, CA)
- …to support health and well-being. Here is a sample of benefit options: Medical , dental, and vision insurance plans UC Retirement Pension Plan Optional life, legal, ... UC Santa Cruz (UCSC) Student Health Services (SHS) is a full-service medical facility offering clinical, educational, and psychological support to UCSC students. SHS… more
- Johns Hopkins University (Chicago, IL)
- …compensation claims . To expand clinic services and reach. Provide crisis management /intervention, as needed. Provide general medical advice to the PepsiCo ... the PepsiCo/JHU partnership. The position also works closely with the Executive Director and Division Administrator of the Division of Occupational and Environmental… more
- Humana (Raleigh, NC)
- …a Lead Medical Director , depending on the line of business. The Medical Director conducts Utilization Management or clinical validation of the care ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Walmart (Bentonville, AR)
- …department. This leader will drive innovation, process improvement, and best-in-class claims management , ensuring alignment with industry best practices and ... **Position Summary ** The Senior Director , Walmart Claims Services Strategy and...(WCS) is dedicated to delivering efficient, accurate, and customer-focused claims management across enterprise. The organization is… more
- Ryder System (Cheyenne, WY)
- …clicking here (http://ryder.com/job-applicant-privacy-policy) ._ **Job Description** : **Summary** The Director Claims directs activities within the General and ... Auto Liability Claims , Physical Damage Repairs and Property and Cargo Claims including the management of loss control activities and third-party provider… more
- AIG (Jersey City, NJ)
- Claims Complex Director - Healthcare Professional... portfolio of the most complex and high exposure medical malpractice (and some GL) claims at ... Liability (HPL) Join us as a Claims Complex Director to take on key...+ Keeps abreast of significant changes in the law, claims and industry trends (not limited to medical… more
- Centene Corporation (Richmond, VA)
- …everything for our 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a diversified, national organization ... enhancing data accuracy, and driving efficiency to support timely and compliant claims outcomes. + Leads utilization management team on performance, improvement,… more
- Humana (Juneau, AK)
- …Typically reports to Lead depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- CVS Health (Hartford, CT)
- …it all with heart, each and every day. **Position Summary:** The Lead Director of Software Engineering is responsible for leading engineering teams that support the ... modernization of legacy systems-primarily IBM Mainframe platforms-used for commercial claims routing, adjudication, and operational reporting. This role ensures the… more
- Aspen Dental (Springfield, IL)
- …proper handling of all claims . Under the general direction of the Director of Risk Management , the Manager is responsible for mitigating, reporting, and ... as a **Risk Management , Claims Manager.** **Job Summary:** The Risk Management Claims Manager will manage the administration of claims for incidents… more
- UNC Health Care (Chapel Hill, NC)
- …health and well-being of the unique communities we serve. **Summary** : Reporting to the Director of Claims & Litigation, the Claims and Litigation Manager ... self-insurance liability programs. This position handles internal investigation process of claims , including analysis of medical records, interviews with… more
- BrandSafway (Atlanta, GA)
- …collaboration with the Senior Counsel for Insured Litigation and the Senior Director - Global Risk Management perform comprehensive internal claim/reserve ... direction of the Senior Counsel - Insured Litigation and Claims will (1) manage assist with managing "Insured Litigation...parties like actuaries, brokers and insurance carriers. Support Senior Director - Global Risk Management as needed… more
- US Tech Solutions (Whittier, CA)
- …will be indicated by a high school diploma or equivalent; four years medical claims processing. **Preferred:** *Department Management to list. **DUTIES ... educational and environmental needs of patient/significant other when administering care. 4.Assist the Claims Director in the training and education of the … more
- Commonwealth Care Alliance (Boston, MA)
- …under the direction of the Sr. Director , TPA Management and Claims Compliance, Healthcare Medical Claims Coding Sr. Analyst will be responsible ... Medicare and Medicaid + 7+ years progressive experience in medical claims adjudication, clinical coding reviews for...and Analytics + Direct and relevant experience with HCFA/UB-04 claims management , coding rules and guidelines, and… more
- Stanford Health Care (Palo Alto, CA)
- …is a Stanford Health Care job.** **A Brief Overview** Under the direction of the Director , Claims & Litigation Strategy, the Claims Manager is primarily ... This position requires coordination with internal stakeholders and external partners. Assists Director , Claims & Litigation Strategy in other EPL claims… more
- MTA (Brooklyn, NY)
- …TA/OA Department: Law Division/Unit: Torts Reports to: Assistant General Counsel / Director of Claims Work Location: 130 Livingston Street, Brooklyn Hours ... aid defense counsel; reviewing and drafting reports for senior management ; serving as liaison between the torts department and...damage claims brought against MTA agencies. Review claims and relevant factual and medical records… more
- Travel + Leisure Co. (Orlando, FL)
- …and structural design is a plus. + 5 years of experience in either property claims management , accounting or project management preferably in the financial ... will play a crucial role as part of a high-performing, results-oriented Risk Management Team. The Senior Property Claims Analyst will be accountable for… more
- UMB Bank (Kansas City, MO)
- …This position will report directly to the Manager, Enterprise Fraud Claims , supporting UMB's protection against multi-channel payment fraud loss. These payment ... Banking, Mobile, Wire, ACH & P2P. Responsible for managing multi-channel fraud claims . Responsible for mastering the associated systems and tools used for managing… more
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