• Director - Complex Claims

    Sedgwick (Minneapolis, MN)
    …place to work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director - Complex Claims **PRIMARY PURPOSE** **:** To be ... responsible for the day to day activities of the complex claims unit, to assess the work done by the unit, and develop and improve the individuals within the… more
    Sedgwick (12/17/24)
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  • Director , Claims (Remote)

    Trustmark (St. Paul, MN)
    …and/or negotiate with claimants and legal representatives. Provides sign-off approval of highly complex or high-dollar claims . + Fosters a culture of continuous ... the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner… more
    Trustmark (11/05/24)
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  • Medical Director -- Claims

    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 (10/29/24)
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  • Medical Director - Florida

    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
    Humana (12/14/24)
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  • Regional Director of Alternative Delivery

    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
    AECOM (11/23/24)
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  • Medical Director - National Medicare Team

    Humana (St. Paul, MN)
    …relies on medical background and reviews preauthorization requests for services. The Medical Director work assignments involve moderately complex to complex ... or data requires an in-depth evaluation of variable factors. The Medical Director for the National Medicare Outpatient Team provides medical interpretation and… more
    Humana (11/08/24)
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  • Corporate Medical Director - Grievances…

    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
    Humana (11/27/24)
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  • Senior Pricing Analyst

    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 (12/19/24)
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  • Construction Professional Liability Underwriter…

    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
    Zurich NA (10/12/24)
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  • Pricing Analyst - REMOTE

    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
    Prime Therapeutics (12/17/24)
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  • General Manager, Stop Loss Product Strategy

    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
    The Cigna Group (11/20/24)
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  • Underwriter

    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 $64,700.00… more
    Prime Therapeutics (12/18/24)
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  • Senior Business Integration Consultant - Remote

    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
    Prime Therapeutics (12/19/24)
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  • VP, Commercial Surety Regional Leader

    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
    Zurich NA (10/10/24)
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  • Technical Principal Clinical Program Pharmacist…

    Prime Therapeutics (St. Paul, MN)
    …You would be tasked with helping to develop, build and manage complex clinical product initiatives.** The Principal Clinical Program Pharmacist is responsible for ... as established. **Responsibilities** + Understand, develop, build and manage complex clinical product initiatives including clinical criteria and associated data… more
    Prime Therapeutics (12/28/24)
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  • Sr. Applied Stars and Quality Analytics Analyst

    Prime Therapeutics (St. Paul, MN)
    …**Preferred Qualifications** + PBM (Pharmacy Benefit Management) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical, ... analysts + Develop analytic methodologies, models, reports and new products + Lead complex client analytical work efforts and serve as an internal subject matter… more
    Prime Therapeutics (12/24/24)
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  • Provider Engagement Manager - Oncology

    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 ... plans and providers to achieve better outcomes for people with the most complex and costly health conditions. Working across specialties and primary care, we seek… more
    Evolent (12/09/24)
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  • Cloud Solutions Architect Leader

    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
    Sedgwick (10/18/24)
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  • Associate People and Culture Business Partner

    YMCA of the North (Minneapolis, MN)
    …processes and initiatives for onboarding documents, independent contractors, unemployment claims , ACA, labor law posters and notifications, data management and ... and resolution; support Business Partner team as needed for complex issues + In collaboration with HR subject matter...as necessary. 3. Relationships: This position reports to the Director of Employee Relations who reports to the Vice… more
    YMCA of the North (12/20/24)
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  • Principal Legal Counsel - Environmental & FDA

    Medtronic (Minneapolis, MN)
    …and geographies resulting in unique ability to 1) advise businesses on complex legal regulatory questions, 2) identify common and conflicting legal issues and ... policy decision-making. This position reports to the Senior Legal Director - Environmental, Health & Safety/Dangerous Goods-Enterprise Legal Regulatory. This position… more
    Medtronic (12/19/24)
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