- Banner Health (Phoenix, AZ)
- …and a minimum of five to seven years medical professional liability management experience, either as in-house claims professional or outside counsel. Must ... Mgmt **Work Shift:** Day **Job Category:** Legal The **Senior Director , Claims & Litigation Counsel** will provide...leadership experience with healthcare risk management , quality management , in house liability claims management… more
- Ryder System (Phoenix, AZ)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
- Humana (Phoenix, AZ)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Phoenix, AZ)
- … 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
- Banner Health (Phoenix, AZ)
- …professional clinical degree and experience with healthcare professional liability claims management . Additional related education and/or experience preferred. ... Rel **Work Shift:** Day **Job Category:** Risk, Quality and Safety The **Senior Director , Clinical Risk Management & Patient Relations** will provide strategic… more
- Centene Corporation (Phoenix, AZ)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Molina Healthcare (Phoenix, AZ)
- …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
- Merck (Phoenix, AZ)
- **Job Description** The Hematology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic and disease expert who ... engages in scientific exchange with leaders in the external medical and scientific community. Scientific exchange does not include promotional claims about any… more
- Prime Therapeutics (Phoenix, AZ)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
- Molina Healthcare (Phoenix, AZ)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... from root cause analysis through implementation * Oversees vendor FWA case management including tracking on schemes, coordinating internal efforts with vendor to… more
- Trustmark (Phoenix, AZ)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
- Intermountain Health (Phoenix, AZ)
- …on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health ... assistant- + Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within four (4) years of… more
- Molina Healthcare (Phoenix, AZ)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the … more
- American Express (Phoenix, AZ)
- …related change management efforts. The manager will report to the Director of Partner Management and Operations Strategy. **Responsibilities:** + Work with ... as our proprietary teams. Additionally, the team is responsible for the management and regulatory aspects of Amex's wholly owned subsidiary, Amex Assurance Company.… more
- Intra-Cellular Therapies, Inc (Phoenix, AZ)
- Benefits Offered 401K, Dental, Life, Medical , Vision Employment Type Full-Time "We deliver innovative treatments to improve the lives of individuals suffering from ... by high impact resource allocation decisions. DMs will assume ownership and the management of a wide range of customer interactions as well as accountability for… more
- Evolent (Phoenix, AZ)
- …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... necessary/required. + Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as… more
- Freeport-McMoRan (Phoenix, AZ)
- …recommends appropriate actions in order to reduce Company's liability. + Support the Director of Contracts Management to establish and develop strategies to ... benefits. **What You Will Do** + Provide input to the Contract Management standards and procedures, including Standard Operating Procedures and Contracts Manual.… more