- Humana (Hartford, CT)
- …driving health outcomes and cost-effective care for our members. We are seeking a Clinical Investigation Lead to provide strategic direction to drive ... owners across Humana to drive solutions forward. In this role you will lead quantitative and qualitative investigations to identify actionable insights and bring… more
- Elevance Health (Wallingford, CT)
- …prior to payment. Researches new healthcare-related questions as necessary to aid in investigations . + Collaborates with the Special Investigation Unit and other ... evaluation of the collected data. + Performs in-depth investigations on identified providers as warranted. + Examines claims...experience, including minimum of 1 year experience in a Clinical Fraud and Abuse Investigation area; or… more
- Moses/Weitzman Health System (Middletown, CT)
- … Chiefs (medical, behavioral health, psychiatric or dental) or the Senior VP & Clinical Director in the investigation of clinical events including sentinel ... **Job Description Summary:** **Job Description:** **NATURE OF POSITION:** The Clinical Risk Manager leads and oversees risk management efforts at CHC and works… more
- Takeda Pharmaceuticals (Hartford, CT)
- …identifying, evaluating, and screening qualified research sites for company sponsored clinical investigation + Actively participates in executing USMAO strategy ... molecular pathways, mechanism of action Takeda Oncology products including clinical outcomes and research opportunities. + Formulate and keep...at medical conferences and may "co- lead " a medical conference to inform for being a… more
- Elevance Health (Wallingford, CT)
- …& Appeals** will be responsible for management oversight of receipt, investigation and processing associated with provider disputes ensuring regulatory compliance, ... of claims, provider contracts and data, eligibility, member contracts, benefits, clinical decisions, pharmacy on pre-service and post service appeals and grievances… more
- Masonicare (Wallingford, CT)
- …other is the IT Desktop Support Technicians. The Desktop Support Supervisor will lead a wide variety of Security Technologies including; tools that safeguard the ... the operational activities in assisting all Masonicare technology users. The Supervisor will lead , supervise and mold the IT Service Desk/Call Center, along with the… more
- The Cigna Group (Bloomfield, CT)
- …with Cigna's Market Medical Executive (MME), Account Management team, clinical consultants and market contracting stakeholders. This is an analytics-based, ... performance drivers and analytic results and providing answers to associated clinical questions are important aspects of this position. Responsibilities +… more
- CVS Health (Hartford, CT)
- …a team in your business area. You will be aligned to projects to lead or contribute to while also participating in networking, development, and career exploration ... and the story they tell, our area supports the relationship that sales, clinical partners, and account managers have with the clients through the analytical lens.… more
- Hartford HealthCare (Mansfield Center, CT)
- …health, residential treatment for court-involved teenage girls, geriatric services, clinical day treatment schools and chemical dependency services. Through our ... human resource support and assists in the daily operation of the HR function. Lead project work and participate in work groups related to streamlining HR processes… more