• Medical Director -- Claims

    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
    Humana (10/29/24)
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  • Business Change Director - Claims

    Elevance Health (Denver, CO)
    **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for...continue to improve on the process. The Business Change Director is responsible for working with management more
    Elevance Health (01/08/25)
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  • Associate Director of Risk…

    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
    University of Colorado (12/20/24)
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  • Associate Director of Risk…

    State of Colorado (Aurora, CO)
    Associate Director of Risk Management , CU Denver and Anschutz Operations Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4767691)  ... Associate Director of Risk Management , CU Denver and...campus leaders on items related to continuously improving risk management processes, risk identification, loss control, claims ,… more
    State of Colorado (12/20/24)
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  • Medical Director - Florida

    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
    Humana (12/14/24)
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  • Medical Director - National Medicare…

    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
    Humana (11/08/24)
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  • Director , Medical Affairs - NYC…

    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
    Merck (12/19/24)
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  • Director , Risk Management

    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, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
    Western Digital (12/27/24)
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  • Medicare Grievances and Appeals Corporate…

    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
    Humana (01/07/25)
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  • Finance & Accounting Assistant Director

    University of Colorado (Aurora, CO)
    **Finance & Accounting Assistant Director ** **Description** **University of Colorado Anschutz Medical Campus** **Department: College of Nursing** **Job Title: ... Compliance: Expertise in fiscal regulatory compliance, cost containment, and timely, accurate claims filing. + Revenue Cycle Management : Skilled in handling… more
    University of Colorado (12/14/24)
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  • Regional Director of Alternative Delivery

    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
    AECOM (11/23/24)
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  • Director , Medicaid Trend Mitigation…

    Humana (Denver, CO)
    …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… more
    Humana (01/08/25)
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  • Health, Safety, and Environment Director

    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
    Fiore & Sons Inc (12/13/24)
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  • Director Healthcare Economics & Trend…

    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, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
    Baylor Scott & White Health (12/21/24)
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  • Actuarial Director , Medicaid Trend…

    Humana (Denver, CO)
    …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
    Humana (01/03/25)
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  • Associate Director , Global Labeling Lead…

    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
    Takeda Pharmaceuticals (10/16/24)
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  • Civil Rights Investigator - HR Specialist III…

    State of Colorado (Denver, CO)
    …evaluation and classification; organizational development; New Employee Orientation; performance management ; interpretation of CDHS HR policy, state personnel rules, ... state and federal employment laws; progressive discipline; records management ; recruitment; responding to grievances, appeals, charges of discrimination;… more
    State of Colorado (01/01/25)
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  • PBM Sr Business Intelligence Data Visual…

    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 + ... with business partners across client facing divisions, product/ project management , analytics, operations, and IT to enable data-driven strategic decisions.… more
    Prime Therapeutics (01/08/25)
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  • Sales Administrator

    Fujifilm (Denver, CO)
    …Sales Administrator for Latin America and the Caribbean will report to the Director of Sales for ID/Optical Devices/ EID. The primary responsibility of this position ... be to support sales for Latin America and Caribbean accounts currently under management by FNAC. Achieve the division sales plan, provide weekly and monthly detail… more
    Fujifilm (01/07/25)
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  • General Manager, Stop Loss Product Strategy

    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
    The Cigna Group (11/20/24)
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