- Humana (Denver, CO)
- … 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
- University of Colorado (Denver, CO)
- **Associate Director of Risk Management , CU Denver and Anschutz Operations** **University of Colorado Denver** **Description** **Who We Are:** **Position ... Posted by the FREE value-added recruitment advertising agency (https://www.jobelephant.com/) Associate Director of Risk Management , CU Denver and Anschutz… more
- Humana (Denver, CO)
- …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
- Conviva (Denver, CO)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
- Humana (Denver, CO)
- … management or utilization management . **Additional Information** Reports to a Lead Medical Director . The Medical Director conducts Utilization ... a part of our caring community and help us put health first** The Medical Director relies on medical background and reviews preauthorization requests… 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 ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Humana (Denver, CO)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- AECOM (Denver, CO)
- …Leads integration of risk/change management processes during delivery, including claims management . + Ensure that project controls measures are implemented. ... select large or complex assignments. + Lead or assist with dispute resolution, claims , and other conflict management issues. + Facilitate planning activities,… more
- Fiore & Sons Inc (Denver, CO)
- …vendors, partners, and employees. The Health, Safety, and Environment Director is responsible for developing, implementing, and maintaining comprehensive health, ... company and all our civil construction projects. The HSE Director manages and motivates a team of dedicated HSE...other applicable agencies as a support partner. + Risk Management : + Identify potential risks and hazards associated with… more
- Baylor Scott & White Health (Denver, CO)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… 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 ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Black Hills Energy (Denver, CO)
- …exams, and PPE. * Support the Insurance and other Departments for the effective management of Worker's Compensation and disability claims , and Human Resources in ... Director of Corporate Safety Location: Denver, CO, United...OSHA and MSHA, to include employee training, facilities, records management , etc. * Foster communication of best practices, accident… more
- CVS Health (Denver, CO)
- …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
- State of Colorado (Golden, CO)
- …for group benefit plan administration. + Collaborate with the Total Rewards Director to evaluate and enhance benefits programs for our State Classified employees, ... and Students. This is a unique opportunity to grow your expertise in benefits management while contributing to a supportive and collegial work culture. If you thrive… more
- Evolent (Denver, CO)
- …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
- Evolent (Denver, CO)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- Prime Therapeutics (Denver, CO)
- …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... **Responsibilities** + Under general supervision, analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… 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....Nutrition + Public Health + Public Administration + Project Management + Communications + Eligibility work + Customer Service… more
- The Cigna Group (Denver, CO)
- …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
- Prime Therapeutics (Denver, CO)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more