- Trustmark (Atlanta, GA)
- …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
- Humana (Atlanta, GA)
- …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
- Zurich NA (Atlanta, GA)
- …Office, AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR ... Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our… more
- Zurich NA (Atlanta, GA)
- …public company Director 's and Officer's (D&O), Fiduciary and transactional risk claims of moderate to high value and complexity. The ideal candidate will have ... Legal Claims Professional- Public D&O 118491 Zurich is currently...AM - Addison, AM - Atlanta, AM - Parsippany Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered:… more
- Sedgwick (Atlanta, GA)
- …to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Client Services ( REMOTE ) **PRIMARY PURPOSE** : To determine ... rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability to… more
- Takeda Pharmaceuticals (Atlanta, GA)
- …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
- Two95 International Inc. (Atlanta, GA)
- Job Title: Director , Health Plan Analytics Job type : Remote Work Type : 6+ Months Contract with extension Rate : $Market /Hour Requirements Position Summary: As ... the Director of Analytics, you will lead a team of...including but not limited to enrollment, finance, call center, claims , Case Management and Utilization Management * 5+ years… more
- US Foods (Norcross, GA)
- …technical and regulatory HSE guidance, as well as responds to issues. This position is remote with up to 70% travel in the Southeast region of the United States. ... interfaces and collaborates with leaders; Legal, HR, Risk Management/ Claims Specialists; Operations leadership. **External:** Key HSE Vendors, Outside Counsel,… more
- HealthEdge Software Inc (Atlanta, GA)
- **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
- Cardinal Health (Atlanta, GA)
- …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Humana (Atlanta, GA)
- …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
- Elevance Health (Atlanta, GA)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... business system integrations. **Location:** This position will work in a hybrid model ( remote and office) with once a week from the nearest Elevance Health… more
- Trustmark (Atlanta, GA)
- …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 Executive Director , Digital Project Manager, as needed. Define baseline and target… more
- Prime Therapeutics (Atlanta, GA)
- …drives every decision we make. **Job Posting Title** Manager, Operations ( Remote ) **Job Description Summary** Responsible for managing, coaching and developing the ... customer complaints. Assumes additional responsibilities in the absence of the Director . **Job Description** + Operations: Manages team members in the project… more
- Prime Therapeutics (Atlanta, GA)
- …decision we make. **Job Posting Title** Data Scientist/Clinical exp preferred- REMOTE **Job Description** The Principal Data Scientist is an independent statistical ... program impact measurement using eligibility, medical, and pharmacy administrative claims and external data, (eg, care management, disease management, laboratory,… more
- Prime Therapeutics (Atlanta, GA)
- …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 (Atlanta, GA)
- …we make. **Job Posting Title** Network Pricing Analyst Principal - Remote **Job Description** The Principal Pricing Analyst leads complex analyses, financial ... 5 years of experience in Pharmacy Benefit Management (PBM), claims processing, healthcare, and/or related field + 3 years...ability to adjust focus **Reporting Structure** + Reports to Director or Senior Director in the Network… more
- Prime Therapeutics (Atlanta, GA)
- …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 (Atlanta, GA)
- …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
- Zurich NA (Atlanta, GA)
- …AM - Remote Work (US) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LC1 #LI- DIRECTOR #LI- REMOTE ... a Property Executive General Adjuster to support our Property Claims division. At Zurich North America Claims ...choosing your next career move. This position is 100% remote and can work anywhere in the United States.… more