- Humana (Hartford, CT)
- … 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 (Hartford, CT)
- …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
- Travelers Insurance Company (Hartford, CT)
- …adequacy, and results. Provides direction for claim technical guidance, legal, and medical issues through a continuous process of management involvement and ... Develop and implement process improvement strategies that impact indemnity, medical , and expense management , investigations, subrogation, structured settlements,… more
- Humana (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- …- Performs benefit-driven medical necessity reviews for coverage, case management , and claims resolution, using benefit plan information, applicable federal ... - Participates in coverage guideline development, development, and maintenance of medical management projects, and committees. - Participates in quality… more
- The Cigna Group (Bloomfield, CT)
- …and support delivery of plan KPIs. + Oversee end-to-end operations, including claims management , contract administration, account management , and producer ... revenue annually with earnings of approximately $1B. The senior director of Stop Loss will be responsible for protecting...risk, and presenting innovative solutions to the market. The management process will pull in dedicated leaders who drive… more
- Elevance Health (Wallingford, CT)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... This high-performing individual contributor will be responsible for working with management to identify and implement varied projects, programs and plans that… more
- CVS Health (Hartford, CT)
- …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 (Hartford, CT)
- …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
- The Cigna Group (Bloomfield, CT)
- The Individual Dental Strategy & Business Development Director will be responsible to maximize Cigna's performance by developing a comprehensive strategy for our ... goals through collaboration with business leaders and owners of relevant management processes, investments, and execution. + Champion strategic change initiatives,… more
- CVS Health (Hartford, CT)
- …Aetna Individual and Family Plans Finance team is looking for a creative Executive Director who will build a Center of Excellence team focused on financial controls. ... This could include leading revenue management best practices for this $10B business, membership reporting...against forecast, across risk adjusted revenue and cost (eg, claims and risk score trends) + Develops the organizations… more
- HomeSafe Alliance (Hartford, CT)
- **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
- Moses/Weitzman Health System (Middletown, CT)
- …**NATURE OF POSITION:** The Clinical Risk Manager leads and oversees risk management efforts at CHC and works collaboratively with the MWHS Legal Department, ... degree. Experience: Minimum 4-5 years of experience in risk management , quality, or public health is required with at...work meets the requirements for the annual Federal Tort Claims Act (FTCA) deeming application and other FTCA reporting… more
- Genesis Healthcare (Bristol, CT)
- …this position is $215000 / year. The Attending Physician works with the Center Medical Director to ensure that delivery of clinical services achieves the ... Attending Physician's Primary reporting relationship is to the AlignMed Partners Regional Medical Director . The Attending Physician is also accountable to both… more
- Prime Therapeutics (Hartford, CT)
- …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
- Aston Carter (Hartford, CT)
- …for our employees. Our team consists of a receptionist, HR generalist, HR director , and an administrator. With around 700 employees, we are looking for someone ... implementation, and other deliverables. + Administer all benefits programs such as medical , dental, vision, life insurance, STD, LTD, and any other benefit… more
- RTX Corporation (Farmington, CT)
- …Manager, Supply Chain (SC) Legal Advisor, who will report to the Associate Director , Raytheon SC Advising. The SC Advisor provides advice and drafting support for ... standard provisions. + Review and advise SC on performance issues such as claims and insolvency. + Assist the organization in writing business processes, policies… more