- Trustmark (Denver, CO)
- …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 (Denver, CO)
- …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
- Merck (Denver, CO)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who engages ... questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific Congress Support, and… more
- Prime Therapeutics (Denver, CO)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Director Account Management, PACE - Remote **Job Description** + Owns overall ... Management Centers (CMC) and Shared Services, assurance of accuracy of claims payment and administrative policies, rate maximization through ongoing benefit analysis… more
- Takeda Pharmaceuticals (Denver, CO)
- …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
- United Therapeutics (Denver, CO)
- …the pharmaceutical and biotech industry, including FDA advertising and promotion, False Claims Act, Anti-Kickback Statute, OIG Guidance, the PhRMA Code, the Sunshine ... Compliance departments related to the Food Drug and Cosmetic Act, the False Claims Act, Anti-Kickback Statute, the Sunshine Act and other healthcare related laws and… more
- HealthEdge Software Inc (Denver, CO)
- **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
- AECOM (Denver, CO)
- …world. Join us. **Job Description** AECOM is seeking an experienced **Regional Director of Alternative Delivery** for this exciting opportunity to oversee the ... with external delivery partners. **_Required responsibilities for the_** **Regional Director of Alternative Delivery** **_include a proven track record of:_**… more
- Humana (Denver, CO)
- …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
- Prime Therapeutics (Denver, CO)
- …every decision we make. **Job Posting Title** Data Visualization Consultant - Remote **Job Description** The Data Visualization Consultant supports the business in ... Under general supervision, analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize...adjust focus **Reporting Structure** + Reports to Principal, Manager, Director , or Sr Director in the Health… more
- Prime Therapeutics (Denver, CO)
- …decision we make. **Job Posting Title** Manager, Reporting & Analytics - Remote **Job Description** The Manager, Reporting and Analytics is responsible for ... + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data...to adjust focus **Reporting Structure** + Reports to a Director or Sr Director in the Operations,… more
- Prime Therapeutics (Denver, CO)
- …we make. **Job Posting Title** Senior Business Integration Consultant - Remote **Job Description** The Senior Business Integration Consultant is responsible for ... efforts + Proficiency in one or more of the following areas: claims , eligibility, prior authorization, accumulators, and/or benefits + Previous PBM or healthcare… more
- Prime Therapeutics (Denver, CO)
- …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
- Zurich NA (Denver, CO)
- …AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Zurich NA (Denver, CO)
- …- Philadelphia, AM - Denver Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 8 or more years of experience in the Claims or Underwriting Support areaAND + Knowledge of Microsoft… more
- Zurich NA (Denver, CO)
- …AM - Los Angeles, AM - Denver Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI- DIRECTOR ... and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 12 or more years of experience in the Claims or Underrwriting Support areaAND + Experience with Microsoft… more
- State of Colorado (Denver, CO)
- …regarding policy and rules and ensure contract compliance. Fair Hearings, Fraud, Claims , & Income Verification: + This role involves supporting the state's ... procedures for fair hearings, fraud detection, claims processing, and income verification within the S-EBT program....Board or request a review by the State Personnel Director . An appeal or review must be submitted on… more
- Zurich NA (Denver, CO)
- …Park, AM - Denver, AM - St. Louis Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI- DIRECTOR ... and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 12 or more years of experience in the Claims or Underwriting Support area Preferred Qualifications: + Bachelors… more
- State of Colorado (Adams County, CO)
- …plus generous vacation and sick leave + Flexible work schedule options and remote -work options + Career advancement opportunities throughout the State system + Some ... providing construction quality assurance, contractor payment processing, writing contractor claims for adjustments and disputes, handling contract terminations, closing… more
- Travelers Insurance Company (Centennial, CO)
- …Opportunity?** Reports to Assistant Vice President, Operations or Operations Director . Implements strategic and tactical operational initiatives. Effectively manage ... direct/manage the account services activities for one or multiple remote sites (ie, 4 - 7 locations, larger territory,...+ Two years of experience in underwriting, service, sales, claims , and/or operations. **What Is in It for You?**… more