- Trustmark (Atlanta, GA)
- …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
- Elevance Health (Atlanta, GA)
- **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model ( remote and office). Ideal ... live within 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for collaborating with… more
- Humana (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Two95 International Inc. (Atlanta, GA)
- Job Title: Director , Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As ... the Director of Analytics, you will lead a team of...including but not limited to enrollment, finance, call center, claims , Case Management and Utilization Management * 5+ years… more
- HealthEdge Software Inc (Atlanta, GA)
- **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
- Educational Testing Service (Atlanta, GA)
- …education and ed tech space as it continues to grow and evolve. The Executive Director of Learning Design will lead the strategy for how ETS develops learning and ... assessment solutions in the K16 Business Unit. The Executive Director will lead a team of learning scientists, instructional designers, user experience research and… more
- Humana (Atlanta, GA)
- …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
- Microsoft Corporation (Atlanta, GA)
- …of those assets. We are looking to fill the critical role of Procurement Director for the Americas region. In alignment with our Microsoft values, we are committed ... location. + This role is eligible for hybrid or remote work, up to (50)%. Microsoft's mission is to...change orders related to long lead equipment. + Negotiate Claims with the detailed understanding of the contractual conditions… more
- Elevance Health (Atlanta, GA)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... business system integrations. **Location:** This position will work in a hybrid model ( remote and office) with once a week from the nearest Elevance Health… more
- RELX INC (Atlanta, GA)
- Director of Data Content and Strategy About the business: LexisNexis Risk Solutions is the essential partner in the assessment of risk. Within our Healthcare ... and experienced professional to join our team as the Director of Data Content and Strategy. This critical role...Maintaining a deep understanding of relevant industry data, including claims , provider data, and patient insights. + Performing all… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …plasma-derived therapies for patients with immunologic, hematologic, and other complex diseases. The Director , Global Labeling Strategy Lead is a key role in the PDT ... others as appropriate) to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure that Takeda products have… more
- Prime Therapeutics (Atlanta, GA)
- …decision we make. **Job Posting Title** Senior Data Visualization Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- Prime Therapeutics (Atlanta, GA)
- …we make. **Job Posting Title** SQL Programmer - Health Data Analyst- Remote **Job Description** The SQL Programmer/Health Data Analyst works collaboratively within ... data output using eligibility data, medical and pharmacy administrative claims . The individual will support pharmaceutical manufacturer value-based contract… more
- Prime Therapeutics (Atlanta, GA)
- …and drives every decision we make. **Job Posting Title** Data Scientist- REMOTE **Job Description** The Principal Data Scientist is an independent statistical ... program impact measurement using eligibility, medical, and pharmacy administrative claims and external data, (eg, care management, disease management, laboratory,… more
- Prime Therapeutics (Atlanta, GA)
- …every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible for leading portions ... Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims , Member Materials, IT, etc.) to ensure effective collaboration,… more
- Zurich NA (Atlanta, GA)
- …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 (Atlanta, GA)
- …Virtual Office, AM - Phoenix Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-WL1 #LI- DIRECTOR ... work collaboratively across business units including but not limited to; claims , finance, risk engineering, actuary, and technical underwriting while gaining… more
- Zurich NA (Atlanta, GA)
- …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