• Director , Claims ( Remote )

    Trustmark (Harrisburg, PA)
    …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
    Trustmark (11/05/24)
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  • Medical Director -- Claims

    Humana (Harrisburg, PA)
    …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
    Humana (10/29/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Harrisburg, PA)
    …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
    Takeda Pharmaceuticals (10/16/24)
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  • CBO Trainer - Claims Trainer (on-site)

    Select Medical (Camp Hill, PA)
    …This position will also be involved in special projects as assigned by the Director of CBO or VP Patient Accounting. **Responsibilities** + Trains new IP CBO team ... both technical and functional on-the-job training for on-site and remote team members. + Creates and keeps up-to-date all...members. + Any additional projects as assigned by the Director of CBO or VP Patient Accounting + Training… more
    Select Medical (08/27/24)
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  • Director , Product Management…

    HealthEdge Software Inc (Harrisburg, PA)
    **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
    HealthEdge Software Inc (09/21/24)
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  • Medicare Grievances and Appeals Corporate Medical…

    Humana (Harrisburg, PA)
    …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
    Humana (10/29/24)
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  • Associate Director - Business Process

    Trustmark (Harrisburg, PA)
    …benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and ... small, mid-size, and complex/transformational projects, with support from the Sr. Director , Business Optimization, as needed. Define baseline and target metrics,… more
    Trustmark (11/13/24)
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  • Senior Compliance Analyst (Regulatory Compliants…

    Prime Therapeutics (Harrisburg, PA)
    …Posting Title** Senior Compliance Analyst (Regulatory Compliants & Inquires) - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Works independently to research and resolve regulatory inquiries/complaints related to claims , contracting and XXXX. Works directly with business partners across the… more
    Prime Therapeutics (11/09/24)
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  • Treasury Reporting Principal - Remote

    Prime Therapeutics (Harrisburg, PA)
    …every decision we make. **Job Posting Title** Treasury Reporting Principal - Remote **Job Description** The Treasury Analyst Principal is responsible for managing, ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more
    Prime Therapeutics (11/12/24)
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  • Regulatory Analyst Sr - Remote

    Prime Therapeutics (Harrisburg, PA)
    …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
    Prime Therapeutics (10/30/24)
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  • Construction Professional Liability Underwriter…

    Zurich NA (Harrisburg, PA)
    …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 (10/12/24)
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  • AVP, E&S Excess Casualty Underwriter

    Zurich NA (Harrisburg, PA)
    …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 (11/13/24)
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  • Senior Design/Construction Management Consulting…

    Zurich NA (Harrisburg, PA)
    …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
    Zurich NA (11/06/24)
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  • Physician Compensation Analyst

    Intermountain Health (Harrisburg, PA)
    …Compensation Analyst provides compensation support and analysis for the Director of Physician Compensation, Manager of Physician Compensation, Medical Group, ... Recruiting, Professional Staff Services, and other leaders. **This is a 100% remote position** **however, currently we are unable to consider candidates for … more
    Intermountain Health (11/05/24)
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  • Coordinator, Intake Utilization Management

    Evolent Health (Harrisburg, PA)
    …Opportunities to work collaboratively with other Clinical Operation Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing ... prior authorization requests and/or relevant health care experience in claims or appeal & grievance is required. + Previous...while balancing a workload and prioritizing assignments in a remote environment. + The ability to connect to router… more
    Evolent Health (11/12/24)
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