- Humana (Raleigh, NC)
- …independent determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage ... caring community and help us put health first** The Project Manager II manages all aspects of a ... + Communicate with other operational areas in the organization to secure specialized resources and contributions for the… more
- Humana (Raleigh, NC)
- …career to the next level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a pivotal ... in resolving outstanding balances related to claim reversals, all while leading process improvements and influencing departmental strategies. This is your chance to… more
- Siemens (Wendell, NC)
- …+ Regularly performs lessons learned activities and feeds the results into own project and organization Ensures proper ramp-up and execution on site. + ... results including budget, financial management of risks, opportunities, claims , scheduling and EHS; acts as owner of his/her...(eg legal, compliance, EHS). + Follows the relevant LoA process as designated Project Manager. + Assesses… more
- Siemens (Wendell, NC)
- …an appropriate reporting structure; supports the implementation of lessons learned into own project and the organization in general. + Manage the risks, contract ... of the future. **We are looking for a Commercial Project Manager / Financial Controller. This position will be...and claims by ensuring compliance with LoA guidelines for commercial… more
- Elevance Health (Cary, NC)
- …prevent unnecessary medical-expense spending. Our Payment Integrity (PI) Operational Excellence organization is looking to hire a ** Process Improvement ... Process Improvement and Lean Six Sigma principles and project leadership. Requires a BA/BS in a related field...experience, with specific knowledge in payment integrity, provider, and claims , and cost-of-care domains. + Process improvement… more
- American Heart Association (Durham, NC)
- …such as code book, Case Report Forms, Surveys, EHR queries and other data project documentation process . + Develop and implement guidelines to manage data ... for you to be able to integrate data from different sources (clinical, claims , patient-reported survey data, food vendors). The Database Designer is responsible for… more
- Guardian Life (Raleigh, NC)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... Managers to get results within their team and the organization . The Team Leader will serve as a primary...action plans for improvement. + Review processes/reports regularly for process improvement opportunities. + Own relationship with client and… more
- Conservation Legacy (Durham, NC)
- …Crews may also complete technical and/or specialized projects depending on project partner needs. CCNC operates programs statewide and year-round and has ... work. We believe that a diverse and inclusive environment enriches our organization , strengthens our mission, and fosters innovation and creativity. CCNC is… more
- Norstella (Raleigh, NC)
- …Now, Citeline is proud to be a part of Norstella, an organization that consists of market-leading pharmaceutical solutions providers united under one goal: ... to improve patient access to life-saving therapies. Within this organization , Citeline plays a key role in helping clients connect the dots from pipeline to patient.… more
- City of Durham (Durham, NC)
- …enrollment data. + Manages the benefit plan selection Request for Proposal (RFP) process in partnership with the City's broker. + Oversees leave policy development, ... administration, and revision and manages the accommodation (ADA) process . + Oversees the administration of the annual open enrollment for benefits and wellness plans… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …* Serves as a liaison between the business programs community and the IT organization to provide technical solutions to meet project needs. * Critically evaluate ... Trust (Hours & Eligibility management), Health Plan Administration (Benefits & Claims Administration, Vendor integration) space. This person must possess a blend… more
- Deloitte (Raleigh, NC)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Deloitte (Raleigh, NC)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- Emerson (Raleigh, NC)
- …Engineer to oversee and manage projects related to feeding systems in our organization . The successful candidate will coordinate and lead projects from conception to ... proposal with the sales team, making adjustments as necessary. Overall Project Responsibility: + Assume end-to-end project responsibility, ensuring consistency… more
- Elevance Health (Cary, NC)
- …communicates requirements to the programming group. + Conduct review of administrative claims data and statistical output to ensure the superior quality of research ... study deliverables and presentation of such and facilitates collaboration among project team members towards their development. **Minimum Requirements:** Requires a… more
- Deloitte (Raleigh, NC)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more
- North Carolina Central University (Durham, NC)
- …* Proficient in statistical analysis, revenue forecasting, financial modeling, project modeling, and business plan development; * Possess comprehensive analytical ... development, implementation, analysis, and planning experience in a complex organization . Master's degree preferred. **Licenses or Certification required by Statute… more
- Prime Therapeutics (Raleigh, NC)
- …Description** + Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out ... reports that give a detailed description of the current project 's progress and indicates time devoted to each task...in easily understandable format for varying levels of the organization . **Responsibilities** + 3+ years of transact-SQL (MS SQL… more
- IQVIA (Raleigh, NC)
- …insurance and adjudication processes + Understanding pharmacy and medical co-pay claims processing + Proficient in cross training in various departments, knowledge ... pharmaceutical industry, including the applications for IQVIA data) + Change management/ process analysis skills. + Strong communication skills, including ability to… more
- Deloitte (Raleigh, NC)
- …the power of hybrid services and products, and unlocking the power of Process Bionics to deliver sustainable and impactful solutions to our clients. We advise, ... relevant processes and technologies for their industry-and apply them with a process and mindset that tailors transformational change to their specific … more