- Trustmark (Albany, NY)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Albany, NY)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… more
- Zurich NA (Albany, NY)
- …Office, AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR ... Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our… more
- Takeda Pharmaceuticals (Albany, NY)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- HealthEdge Software Inc (Albany, NY)
- **Overview** ** Director , Product Management** **Position Overview:** We are seeking a highly skilled and experienced Director of Product Management to lead our ... and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream… more
- CDPHP (Albany, NY)
- …and invites you to be a part of that experience. The Medical Director , Behavioral Health, Child & Adolescent Programs will conduct utilization review oversight, ... across all lines of business. In addition, the Medical Director will be assigned to oversee the unique needs...Excel, Outlook and PowerPoint is required. + Knowledge of claims management systems is preferred. + Ability to learn… more
- Cardinal Health (Albany, NY)
- …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Humana (Albany, NY)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Trustmark (Albany, NY)
- …benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and ... small, mid-size, and complex/transformational projects, with support from the Executive Director , Digital Project Manager, as needed. Define baseline and target… more
- Zurich NA (Albany, NY)
- …AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- New York State Civil Service (Albany, NY)
- …and Director of Construction Management regarding contractor's disputed work claims Assist our Legal Department regarding claims on construction contracts ... TA Addendum Provide guidance in handling of disputed work claims at the field and Division level Attend project...our Consultant inspection Additional Comments Free onsite employee parking. Remote work availability and hours will be discussed at… more
- Zurich NA (Albany, NY)
- …Office, AM - Oregon Virtual Office Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LB1 #LI- DIRECTOR ... prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims...for resume submission. Location(s): AM - Schaumburg, AM - Remote Work (US), AM - Dallas, AM - San… more
- HomeSafe Alliance (Albany, NY)
- …with GHC pricing requirements and report actual performance monthly to the Director of International Operations (DIOps) + Verify and assess accuracy of transit ... risks of not meeting RDDs as directed by the Director of International Operations, for all shipments that may...International Operations, for all shipments that may create inconvenience claims for HomeSafe. Formats and data requirements to be… more
- Evolent Health (Albany, NY)
- …Opportunities to work collaboratively with other Clinical Operation Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing ... prior authorization requests and/or relevant health care experience in claims or appeal & grievance is required. + Previous...while balancing a workload and prioritizing assignments in a remote environment. + The ability to connect to router… more