- Trustmark (Denver, CO)
- …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 (Denver, CO)
- …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
- Merck (Denver, CO)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support, and… more
- Prime Therapeutics (Denver, CO)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Director Account Management, PACE - Remote **Job Description** + Owns overall ... Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis… more
- Takeda Pharmaceuticals (Denver, CO)
- …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
- United Therapeutics (Denver, CO)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... Compliance departments related to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other healthcare related laws and… more
- AECOM (Denver, CO)
- …world. Join us. **Job Description** AECOM is seeking an experienced **Regional Director of Alternative Delivery** for this exciting opportunity to oversee the ... with external delivery partners. **_Required responsibilities for the_** **Regional Director of Alternative Delivery** **_include a proven track record of:_**… more
- Western Digital (Denver, CO)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... requirements. + Insure the proper and efficient handling of claims as they relate to workers' compensation insurance requirements....to be performed in California, Colorado, New York or remote jobs that can be performed in California, Colorado… more
- Humana (Denver, CO)
- …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Prime Therapeutics (Denver, CO)
- …decision we make. **Job Posting Title** Manager, Reporting & Analytics - Remote **Job Description** The Manager, Reporting and Analytics is responsible for ... + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data...to adjust focus **Reporting Structure** + Reports to a Director or Sr Director in the Operations,… more
- Prime Therapeutics (Denver, CO)
- …and drives every decision we make. **Job Posting Title** Underwriter - Remote **Job Description** The Underwriter is responsible for assisting in the development ... Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims data +… more
- Prime Therapeutics (Denver, CO)
- …we make. **Job Posting Title** Senior Business Integration Consultant - Remote **Job Description** The Senior Business Integration Consultant is responsible for ... efforts + Proficiency in one or more of the following areas: claims , eligibility, prior authorization, accumulators, and/or benefits + Previous PBM or healthcare… more
- Prime Therapeutics (Denver, CO)
- …we make. **Job Posting Title** Technical Principal Clinical Program Pharmacist - Remote **Job Description** **We are offering a great opportunity for a pharmacist ... Gather, analyze, and synthesize market information, clinical guidelines and member claims data to support clinical product management initiatives, products and… more
- Prime Therapeutics (Denver, CO)
- …every decision we make. **Job Posting Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more
- Zurich NA (Denver, CO)
- …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
- Zurich NA (Denver, CO)
- …- Philadelphia, AM - Denver Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft… more
- Zurich NA (Denver, CO)
- …AM - Los Angeles, AM - Denver Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI- DIRECTOR ... and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 12 or more years of experience in the Claims or Underrwriting Support areaAND + Experience with Microsoft… more
- State of Colorado (Denver, CO)
- …Opportunity Commission (EEOC) and Colorado Civil Rights Division (CCRD) claims , appeals, and charges of discrimination; settlement advice; benefits administration; ... and identifying and communicating trends in employee civil rights claims and issues with potential legal implications. This position...Board or request a review by the State Personnel Director . An appeal or review must be submitted on… more
- State of Colorado (Denver, CO)
- …regarding policy and rules and ensure contract compliance. Fair Hearings, Fraud, Claims , & Income Verification: + This role involves supporting the state's ... procedures for fair hearings, fraud detection, claims processing, and income verification within the S-EBT program....Board or request a review by the State Personnel Director . An appeal or review must be submitted on… more
- Zurich NA (Denver, CO)
- …Park, AM - Denver, AM - St. Louis Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI- DIRECTOR ... and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 12 or more years of experience in the Claims or Underwriting Support area Preferred Qualifications: + Bachelors… more