- Humana (St. Paul, MN)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Humana (St. Paul, MN)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- AECOM (Minneapolis, MN)
- …infrastructure consulting firm, partnering with clients to solve the world's most complex challenges and build legacies for future generations. There has never been ... world. Join us. **Job Description** AECOM is seeking an experienced **Regional Director of Alternative Delivery** for this exciting opportunity to oversee the… more
- Humana (St. Paul, MN)
- …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Merck (St. Paul, MN)
- **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
- Evolent (St. Paul, MN)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek… more
- Zurich NA (St. Paul, MN)
- …+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims . + Ability to follow reserving process for indemnity and ... expense in analyzing the potential exposure of complex claims . + Ability to determine the...Office, US_55 (US_55) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LC1 #LI- DIRECTOR … more
- Prime Therapeutics (St. Paul, MN)
- …or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic insight to ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Eagan, MN)
- …requirements, process improvement, advanced research, root cause analysis, complex issue research, documentation, advanced communications, client interaction, ... researches, determines root cause and collaborates with others to resolve complex business and technical issues and customer inquiries. + Provides prompt… more
- Prime Therapeutics (St. Paul, MN)
- …new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to ... based upon large data sets and/or experience working with complex queries + 3 years of experience with dashboard...+ Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- Prime Therapeutics (Eagan, MN)
- …with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness & ... accuracy of Prime's financial pricing programs against adjudicated claims to identify trends and draw insights to provide...accuracy + Demonstrated ability to problem solve and interpret complex data + Ability to work independently and meet… more
- Zurich NA (St. Paul, MN)
- …Liability Underwriter, (Sr. Level III or AVP Level IV) you will handle complex new and renewal domestic Construction Professional Liability accounts and serve as a ... Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate… more
- The Cigna Group (Bloomington, MN)
- …in over $4B of revenue annually with earnings of approximately $1B. The senior director of Stop Loss will be responsible for protecting and growing this business ... solutions that enhance affordability and improve the predictability of high-cost claims for clients. + In partnership with Cigna's Affordability, Governance, &… more
- Mathematica (St. Paul, MN)
- …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 ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more
- Prime Therapeutics (St. Paul, MN)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims ... and ability to adjust focus **Reporting Structure** + Reports to Manager or Director in the Finance Department Potential pay for this position ranges from $59,000.00… more
- Prime Therapeutics (St. Paul, MN)
- …The Senior Business Integration Consultant is responsible for leading multiple complex small to mid-sized client and/or product implementations, projects, analysis, ... and external leaders + Ability and desire to drive solutions for complex business needs (including operational and technical aspects) + Familiarity with project… more
- Zurich NA (Edina, MN)
- …Surety Regional Leader 113231 Zurich is currently looking for a VP, Territory Director for our Commercial Surety Group in the Central Region. The Central region ... and oversight on strategic underwriting practices. The VP, Territory Director , Commercial Surety is responsible for: + Managing a...Degree with 20 or more years of experience in Claims or Underwriting Support area within the Commercial Insurance… more
- Sedgwick (Minneapolis, MN)
- …cloud-based infrastructure services in conjunction with senior IT management. The Director Infrastructure Services - Cloud designs and drives the implementation of ... Azure enterprise solutions. Must show proven ability to architect highly complex scalable cloud solutions across a global enterprise. **Skills & Knowledge**… more
- Prime Therapeutics (St. Paul, MN)
- …is responsible for managing, analyzing, and delivering Treasury reporting, including complex liquidity reporting and claim payment process reporting for a variety ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more
- Danaher Corporation (New Brighton, MN)
- …a part of the Regulatory Affairs and Quality Affairs and report to the Director , Regulatory Affairs responsible for an RA team that supports new product development ... Experience with giving both scientific and regulatory input to claims , test plans, test protocols (non-clinical and clinical) +...across the globe to help them solve their most complex challenges, architecting solutions that bring the power of… more