- Ryder System (Salem, OR)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
- Humana (Salem, OR)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Salem, OR)
- … 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
- Molina Healthcare (Vancouver, WA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Merck (Salem, OR)
- **Job Description** The Hematology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic and disease expert who ... engages in scientific exchange with leaders in the external medical and scientific community. Scientific exchange does not include promotional claims about any… more
- Pacific Seafood (Clackamas, OR)
- …benefits, payroll, training and development, internships, compliance, policies and HR risk management . The Central Support HR Director must be a "hands ... striving to do better. Summary: The Central Support HR Director for Pacific Seafood is a key member of...to the company, including health insurance, 401(k), and leave management . + Oversee a team that delivers timely and… more
- Prime Therapeutics (Salem, OR)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
- Molina Healthcare (Vancouver, WA)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... from root cause analysis through implementation * Oversees vendor FWA case management including tracking on schemes, coordinating internal efforts with vendor to… more
- Trustmark (Salem, OR)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
- Northwest Human Services (Salem, OR)
- …analyze data to identify trends and areas for improvement. + Assist in the Claims Management process by reviewing and updating policies and tools, and support ... are a mission focused organization providing compassionate and professional medical , dental, psychiatry, mental health, and wraparound services for...FTCA Claims management for timely submissions. + Monitor… more
- Intermountain Health (Salem, OR)
- …on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health ... assistant- + Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within four (4) years of… more
- Molina Healthcare (Vancouver, WA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the … more
- Evolent (Salem, OR)
- …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... necessary/required. + Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as… more
- PeaceHealth (Vancouver, WA)
- …and teaching skills. (Required) + Understanding of the principles of project management , including documentation and communication. (Required) + Ability to work with ... deadlines. (Required) Department / Location Specific Notes For Health Information Management Coding: *Informaticist will project manage, identify, develop, build and… more
- CareOregon (Portland, OR)
- …and/or Education Required + Seven years' experience in the analysis of health insurance, medical claims and financial or related data using SAS or other ... Manager Exemption Status Exempt Department Informatics & Evaluation Manager Title Director , Data Science & Informatics Direct Reports (varies by team) Requisition… more
- CareOregon (Portland, OR)
- …Status Exempt Management Level n/a Direct Reports n/a Manager Title Director Risk Adjustment Department Finance Pay and Benefits Estimated hiring range $71,340 - ... coding guidelines and best practices while promoting compliance with existing American Medical Association (AMA) and Centers for Medicare and Medicaid Services (CMS)… more