- Humana (St. Paul, MN)
- … Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members ... **Become a part of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement… more
- Sedgwick (Minneapolis, MN)
- …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 ... negotiation, mediation, arbitration, or ADR skills on higher value complex claims . Management experience preferred. Specific jurisdictional expertise required.… more
- Humana (St. Paul, MN)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Director , depending on size of region or line of business. The Medical Director conducts Utilization Management of the care received by members in an… more
- Humana (St. Paul, MN)
- … 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
- Merck (St. Paul, MN)
- **Job Description** **Role Summary** The Regional Medical Scientific Director is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert who ... SLs, including questions about Company products. The work of an Regional Medical Scientific Director is aligned to: Scientific Exchange, Research, Scientific… more
- Humana (St. Paul, MN)
- …of our dynamic Wisconsin leadership team in this position as the Director , Consumer Service Operations. This position works with insurance companies, providers, ... members, and collection services in the settlement of claims through Call Center operations. Comprised of a team of claims associates researching & resolving the… more
- Western Digital (St. Paul, MN)
- …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
- Humana (St. Paul, MN)
- …help us put health first** The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director ... of diverse scope and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the… more
- Fairview Health Services (St. Paul, MN)
- **Overview** The Director of Revenue Cycle provides leadership and accountability for operational excellence of one or more of the major functions within Revenue ... Cycle. The Director of Revenue Cycle will implement effective strategies to...Job Description** **Job Expectations:** + Provides Strategic Direction for management of the Charge Description Master (CDM) and fee… more
- AECOM (Minneapolis, MN)
- …Leads integration of risk/change management processes during delivery, including claims management . + Ensure that project controls measures are implemented. ... select large or complex assignments. + Lead or assist with dispute resolution, claims , and other conflict management issues. + Facilitate planning activities,… more
- HomeSafe Alliance (St. Paul, MN)
- **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
- Baylor Scott & White Health (St. Paul, MN)
- … claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
- Humana (St. Paul, MN)
- …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
- Takeda Pharmaceuticals (St. Paul, MN)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
- Fairview Health Services (Minneapolis, MN)
- …and Execution (35%):** + Involved in the development, implementation, and management of a comprehensive, market-based payer strategy. + Direct innovative programs, ... risk methodology and algorithms, data analytics, and health outcomes research. **Account Management & Sales (20%)** + Account and relationship management of… more
- HomeSafe Alliance (St. Paul, MN)
- **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
- Evolent (St. Paul, MN)
- …and LPCs, Clinical Reviewers. Opportunities to work collaboratively with other Utilization Management Leaders including our Director may also be available. ... culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of...also works with our clinical team, which includes our medical reviews: LVNs, LPNs, and RNs along with our… more
- AON (Bloomington, MN)
- …to internal and external clients. + Working with the Resident Managing Director , leads critical best practice client management efforts including Strategic ... to assist clients in unusual circumstances such as large claims , etc. + Helps resolve internal issues with geographies,...and external clients. + Working with the Resident Managing Director , leads critical best practice client management … more
- The Cigna Group (Bloomington, MN)
- …and support delivery of plan KPIs. + Oversee end-to-end operations, including claims management , contract administration, account management , and producer ... revenue annually with earnings of approximately $1B. The senior director of Stop Loss will be responsible for protecting...risk, and presenting innovative solutions to the market. The management process will pull in dedicated leaders who drive… more
- Prime Therapeutics (St. Paul, MN)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more