- Humana (Salt Lake City, UT)
- … 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 Utah Health (Murray, UT)
- …years of experience collecting, organizing and maintaining health insurance and processing medical claims , enrollment, and familiarity with medical coding, ... that are integral to our mission. EO/AA_ + This position is responsible for auditing claims and customer service calls for UUHP. + The Claims and Customer… more
- Humana (Salt Lake City, UT)
- …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 (Salt Lake City, UT)
- … 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 (Salt Lake City, UT)
- **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
- Western Digital (Salt Lake City, UT)
- …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
- Molina Healthcare (Provo, UT)
- …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
- Apartment Management Consultants, LLC (Salt Lake City, UT)
- We are currently seeking a Director of Risk Management ! The Head of Risk Management will develop, execute, and administer the insurance and risk strategy for ... of AMC. Responsibilities include: + Lead the design, implementation, and ongoing management of the company's new Master Insurance Program, ensuring consistency of… more
- University of Utah Health (Salt Lake City, UT)
- …the University of Utah Hospitals and Clinics. This roleensures seamless management of patient billing, insurance verification, claims processing, collections, ... Administration, or related area or equivalency. + Six years of progressive management experience, preferably within an academic medical center or complex… more
- Baylor Scott & White Health (Salt Lake City, UT)
- … 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
- Humana (Salt Lake City, UT)
- …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
- Takeda Pharmaceuticals (Salt Lake City, UT)
- …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
- Molina Healthcare (Provo, UT)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... (SIU) to oversee the special investigations unit vendor outlier analytics and case management system, training and implementation. Serves as a backup for the AVP of… more
- Christian Center of Park City (Park City, UT)
- …Department : Counseling and Wellness Center Reports to: Counseling Programs Assistant- Director Pay Range: $23-$27/h Schedule: Mon-Fri 9a-5p (29 hours/week) Location: ... clients. This role manages relationships with billing service providers, coordinates claims and reimbursements, and ensures compliance with billing standards. The… more
- Evolent (Salt Lake City, UT)
- …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 (Salt Lake City, UT)
- …+ 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
- University of Utah (Salt Lake City, UT)
- …managers/case workers, and patients, regarding the status of funding. Works with Medical Director , physicians, and billing offices to determine cost estimates ... Seldom: Bending, reaching overhead. **Minimum Qualifications** Four years experience with medical accounts receivable, insurance claims , or equivalency (one year… more
- Mathematica (Salt Lake City, UT)
- …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and… more
- SitusAMC (Salt Lake City, UT)
- …team! This role is responsible for aligning business goals with employees and management . The position should anticipate HR needs in a proactive manner and ... communicate these requirements and potential solutions to the management team. This position is the HR point of contact for management and employees for their… more
- Stantec (Salt Lake City, UT)
- … activities as assigned by and in support of Project Manager / Project Director + Conducts budget and schedule management + Participate in activities of ... help clients achieve their organization's objectives. Join our award-winning program management team and bring transformational project solutions to life. By… more