- Humana (Phoenix, AZ)
- … 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
- Banner Health (Phoenix, AZ)
- …and a minimum of five to seven years medical professional liability management experience, either as in-house claims professional or outside counsel. Must ... Mgmt **Work Shift:** Day **Job Category:** Legal The **Executive Director , Claims & Litigation Counsel** will provide...leadership experience with healthcare risk management , quality management , in house liability claims management… more
- USAA (Phoenix, AZ)
- …part of what makes us so special! **The Opportunity** We are seeking a dedicated Claims Litigation Case Manager Senior. This position is a hybrid work type and can ... resource for colleagues with less experience. + Applies advanced knowledge of claims litigation processes. + Proactively manages litigation and acts as liaison with… more
- Humana (Phoenix, AZ)
- …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
- USAA (Phoenix, AZ)
- …Investigations Unit (SIU),** you will be responsible for Life, Annuity & Health claims and fraud investigation programs and management of the Life Special ... guidelines, and training reference materials. + Oversees decisions made within the claims and benefits process. + Approves claims within assigned authority… more
- Molina Healthcare (Phoenix, AZ)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Humana (Phoenix, AZ)
- …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
- CVS Health (Phoenix, AZ)
- …health care more personal, convenient and affordable. **Position Summary** The Lead Director of value based contracting and business development is responsible for ... annual bid process. The position will work closely with the Engagement Management resources responsible for optimizing performance of our VBC agreements to ensure… more
- CVS Health (Scottsdale, AZ)
- …in new and exciting ways every day. Aetna is recruiting for an Executive Director , Claim Platform Quality Assurance for the Claims Center of Excellence ... CVS Health's unrivaled presence in local communities and their pharmacy benefits management capabilities, we're joining members on their path to better health and… more
- Takeda Pharmaceuticals (Phoenix, AZ)
- …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
- USAA (Phoenix, AZ)
- …Standards, BSA/AML, REG E, UDAAP/UDAP. **What sets you apart:** + 5+ years of fraud or claims management + Deep knowledge of Reg E, Reg Z and UDAAP + Proven, ... continental US with occasional business travel. **The Opportunity** As a dedicated Director , Dispute Transformation, you will be responsible for overseeing a team of… more
- CVS Health (Phoenix, AZ)
- …health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by leading ... executive, providers, and administrative staff. + Relationship building + Medical cost, risk, and quality analysis + Transforming data...in a care delivery setting, population health and care management + 5+ years of strong Medicare and clinical… more
- CVS Health (Phoenix, AZ)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...- May assist in the research and resolution of claims payment issues. - Supports the administration of the… more
- LifePoint Health (Lake Havasu City, AZ)
- …codes to individual patient health information for data retrieval, analysis, and claims processing. Reports to: Director AZ Physician Services FLSA: Non-exempt ... applicable federal, state, or local law. **Job:** **Health Information Management /Coding* **Organization:** **Havasu Regional Medical Center* **Title:**… more
- ASRC Industrial Services (Phoenix, AZ)
- …Corporation (ASRC), an Alaska Native Corporation (ANC) established under the Alaska Native Claims Settlement Act of 1971. As part of an ANC all our operating ... range of benefits including: generous PTO plan, paid holidays, medical , dental, vision, 401K (100% match up to 4%...Environmental Health and Safety Manger (HSM) supports the HSE Director at the corporate, program, and project level to… more
- Prime Therapeutics (Phoenix, AZ)
- …and program impact measurement using eligibility, medical , and pharmacy administrative claims and external data, (eg, care management , disease management ... advanced scientific model design, including advanced predictive modeling, with health claims data, applying statistical theories and methods to solve complex… more
- Freeport-McMoRan (Phoenix, AZ)
- …recommends appropriate actions in order to reduce Company's liability. + Support the Director of Contracts Management to establish and develop strategies to ... benefits. **What You Will Do** + Provide input to the Contract Management standards and procedures, including Standard Operating Procedures and Contracts Manual.… more