- Prime Therapeutics (Raleigh, NC)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Senior Claims Operations Business Analyst - Remote **Job Description ... Summary** Serves as liaison between departmental team business owners, end users, IT, Claims and...Medicare, requires 3+ years of experience working in Medicare Operations . **Work Experience** Work Experience - Required: Business… more
- Humana (Raleigh, NC)
- …caring community and help us put health first** The Senior Pharmacy Claims Operations Professional oversees the business processes and ensures accuracy ... of sale transition adjudicated claims logic. The Senior Pharmacy Claims Operations Professional...**Responsibilities** The Senior Pharmacy Claims Operations Professional analyzes, monitors and enhances business … more
- Prime Therapeutics (Raleigh, NC)
- …make. **Job Posting Title** Claims Technical Analyst, Sr. **Job Description** The Senior Claims Technical Analyst is responsible for serving as the claims ... This role is also responsible for providing training and mentorship to Claims Technical Analysts and Associate Analysts, along with leading process improvement and… more
- Deloitte (Raleigh, NC)
- Senior Consultant, Operations & Technology Transformation, Insurance, Guidewire Integration & Configuration What we do Operations and Technology ... and technology solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems strategy, develop system… more
- Deloitte (Raleigh, NC)
- Operations Technology Transformation Senior Consultant, Guidewire Configuration / Integration What we do Operations and Technology Transformation delivers ... and technology solutions, helping to create technology solutions to meet clients' business needs. Senior Consultants will define systems strategy, develop system… more
- Deloitte (Raleigh, NC)
- Senior Consultant, Operations and Technology Transformation, Guidewire Application Java Developer What we do Operations and Technology Transformation ... and technology enabled solutions focused on "heart of the business " issues in specific sectors including Health Care &...2025 Work you'll do As an OTT Insurance Transformation Senior Consultant, you will bring technical expertise to deliver… more
- HealthEdge Software Inc (Raleigh, NC)
- …integrated solutions suite includes the industry's leading, digital, next-generation claims administration processing system, business intelligence, integration ... **Overview** ** Senior Manager, Product Operation** **Position Overview:** We areseekinga...our product teams to solve hard problems-customer problems and business problems-in ways that our customers love and that… more
- The Cigna Group (Raleigh, NC)
- …- Required + Teradata and Databricks - Preferred + Ability to understand business operations requirements and translate them into technical applications + ... **Summary** The Part D Stars Business Analytics Senior Advisor will be...Advisor will lead development of data analyses utilizing pharmacy claims , clinical outcomes, and Stars quality measures to make… more
- MetLife (Cary, NC)
- …a month for office meetings Key Responsibilities: * Conduct quality reviews of LTD claims of various complexity * Identify trends, root causes and quality gaps from ... and management regarding performance and quality standards * Partners with team and claims organization to develop criteria and standards in which to measure quality… more
- CVS Health (Raleigh, NC)
- …which contain multiple issues and may require coordination of responses from multiple business units. Appeals are typically more complex and may require outreach and ... Serves as point person for newer staff in answering questions associated with claims /customer service systems and products. Educates team mates as well as other… more
- Sedgwick (Raleigh, NC)
- …work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Senior Vice President Business Development **PRIMARY PURPOSE:** To expand and ... their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our… more
- Zurich NA (Raleigh, NC)
- Senior US International Reverse Flow Underwriter 117849 Zurich is seeking a senior level US International Reverse Flow Underwriter to join our International ... Operations team in our Schaumburg, IL North America Headquarters....provide US underwriting support for incoming received country (RC) business from non-US producing countries. In this model the… more
- Evolent Health (Raleigh, NC)
- …products. You will collaborate with cross-functional teams, including solution strategy, business operations , engineering, quality assurance, and IT, to ensure ... You'll Be Doing:** **What You'll Be Doing:** As a Senior Product Analyst, you will have the opportunity to...market, and the customers. They collaborate with implementation teams, business operations , engineering, and growth teams to… more
- Prime Therapeutics (Raleigh, NC)
- …across the organization to validate regulatory requirements are met and that business operations are aligned with expectations of applicable regulatory guidance ... guidance and regulatory issues that impact Prime's compliance programs or business operations ; document requirements or disciplinary actions and escalate… more
- Amgen (Holly Springs, NC)
- … advisor, providing thought leadership and consistent customer service to Operations Engineering business partners + Collaborate with Engineering Stakeholders ... and transform the lives of patients while transforming your career. **Strategic Sourcing Senior Manager - Capital Construction** **What you will do** Let's do this.… more
- Humana (Raleigh, NC)
- …support the strategic direction and growth of the Medicaid and Duals lines of business . This is a unique opportunity for a motivated individual to influence the ... successfully position Humana to enter new markets enabling the future of the business . As a centrally positioned strategic function this team coordinates with growth… more
- Deloitte (Raleigh, NC)
- …in the face of disruption. Our team is a diverse array of business strategists, operations experts, designers and technologists passionate about partnering with ... Life Sciences Market Access Senior Manager An evolving customer and regulatory landscape,...are requiring new levels of rigor and insight in business strategy development and problem-solving, both domestically and globally,… more
- Fujifilm (Raleigh, NC)
- …please visit_ _healthcaresolutions-us.fujifilm.com_ _._ **External US** **Job Title:** ** Senior Compliance Specialist** **Job purpose** The accomplished Senior ... Compliance Specialist will support FUJIFILM's Corporate compliance program operations to ensure high ethical standards are observed and compliance program is… more
- Affordable Care (Morrisville, NC)
- …strategy through the development of tools, reporting, and new visibility to our business and patients, and this position will accomplish that through a strong blend ... of technical acumen and business understanding. **Responsibilities** **GENERAL DUTIES & RESPONSIBILITIES:** + Leverage...+ Partner cross functionally across insurance, product, marketing, and operations to bring a pricing strategy to life that… more
- Cardinal Health (Raleigh, NC)
- …colleagues as a coveted member of the Product Experience organization. As a Senior Product Experience Designer, you will define, lead, and implement the analytics ... their practices' financial performance. These products help monitor drug utilization, claims payment and denials, reimbursement trends, margins, and provide insights… more