- Humana (Nashville, TN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **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
- Humana (Nashville, TN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (Nashville, TN)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… more
- Dialysis Clinic, Inc. (Nashville, TN)
- …potential liability risks for DCI. + Participate in medical and general liability claims management and coordinate with Director of Insurance on claim ... Summary:** We are seeking a highly skilled and experienced Director of Risk Management to join our...+ Minimum of 5-7 years of experience in risk management , including claims administration, preferably in a… more
- Merck (Nashville, TN)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Western Digital (Nashville, TN)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
- Humana (Nashville, TN)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Ascension Health (Nashville, TN)
- …the TN market. Must be located within TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, ... optimize patient care, and partner with the National Senior Director of UM to align on organizational goals. Ready...within the insurance plan. + Ensure integration of utilization management functions with network strategy and claims … more
- Merck (Nashville, TN)
- …needs to support collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, ... **Job Description** Our Medical Affairs team advances patient care by engaging...and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
- Cardinal Health (Nashville, TN)
- …and delivers human resource programs and policies, including recruitment, talent management , diversity and inclusion, compensation and benefits, among others. This ... **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the...Benefits to lead and oversee the design, implementation, and management of employee benefit programs. This role will be… more
- Humana (Nashville, TN)
- …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… more
- HomeSafe Alliance (Nashville, TN)
- **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
- Baylor Scott & White Health (Nashville, TN)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
- Elevance Health (Nashville, TN)
- …and utilizes multiple systems. May include oversight of multiple functions within claims , customer service, enrollment and billing, document management , mail ... ** Director of Customer Care II** **Location:** This role...goals strongly preferred. + Experience interacting confidently with senior management and executive level stakeholders, as a subject matter… more
- Takeda Pharmaceuticals (Nashville, TN)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Wellpath (Nashville, TN)
- …Risk Management department, including a specialized correctional health clinical claims director nurse, to develop a comprehensive risk management ... to the Chief Legal Officer, this role oversees the Claims Management team, the company's insurance portfolio,...handling medical malpractice litigation and professional liability claims management is a requirement of the… more
- Jennie Stuart Medical Center, Inc. (Hopkinsville, KY)
- Works daily electronic billing file and submits insurance claims to third party payers. Reviews, evaluates, and forwards manual patient account statements to payers ... that do not accept electronic claims or that require special handling such as client...trends and issues; reports these findings to supervisor or director . Practices excellent customer service skills by answering patient… more
- Marriott (Nashville, TN)
- …**Schedule** Full Time **Located Remotely?** N **Position Type** Management **JOB SUMMARY** As a member of the property ... * High school diploma or GED; 3 years experience in the human resources, management operations, or related professional area. OR * 2-year degree from an accredited… more
- HomeSafe Alliance (Nashville, TN)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Prime Therapeutics (Nashville, TN)
- …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... with business partners across client facing divisions, product/ project management , analytics, operations, and IT to enable data-driven strategic decisions.… more