- Trustmark (Hartford, CT)
- …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 (Hartford, CT)
- …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
- Takeda Pharmaceuticals (Hartford, CT)
- …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
- The Hartford (Hartford, CT)
- Director & Actuary - AM06AEDirector & Assistant Actuary - AM06BE We're determined to make a difference and are proud to be an insurance company that goes well beyond ... help shape the future. This role can be a Director & Actuary or Director & Assistant...work closely with other Actuarial partners as well as Claims Performance Analytics, Product, and Data Science. Responsibilities: +… more
- HealthEdge Software Inc (Hartford, CT)
- **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
- Educational Testing Service (Hartford, CT)
- …education and ed tech space as it continues to grow and evolve. The Executive Director of Learning Design will lead the strategy for how ETS develops learning and ... assessment solutions in the K16 Business Unit. The Executive Director will lead a team of learning scientists, instructional designers, user experience research and… more
- Humana (Hartford, CT)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Elevance Health (Wallingford, CT)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... business system integrations. **Location:** This position will work in a hybrid model ( remote and office) with once a week from the nearest Elevance Health… more
- Molina Healthcare (Springfield, MA)
- **_ Remote and must live in Massachusetts _** **Job Description** **Job Summary** Provides leadership and direction to MMS Operational Units management staff (eg, ... Claims Processing, Provider Services, Provider Enrollment, Finance, Managed Care...goals with assigned department managers, in conjunction with the Director , Account Management so that department goals support overall… more
- Prime Therapeutics (Hartford, CT)
- …decision we make. **Job Posting Title** Senior Data Visualization Consultant - Remote **Job Description** The Senior Data Visualization Consultant is responsible for ... new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
- RTX Corporation (East Hartford, CT)
- Date Posted: 2024-10-30 Country: United States of America Location: RCO99: RTN Remote , Colorado Position Role Type: Remote At Raytheon, the foundation of ... (SC) Legal Advisor, who will report to the Associate Director , Raytheon SC Advising. The SC Advisor provides advice...information agreements, and other agreement types. This position is remote ; the ideal candidate will be located within 50… more
- Prime Therapeutics (Hartford, CT)
- …and drives every decision we make. **Job Posting Title** Data Scientist- REMOTE **Job Description** The Principal Data Scientist is an independent statistical ... program impact measurement using eligibility, medical, and pharmacy administrative claims and external data, (eg, care management, disease management, laboratory,… more
- Prime Therapeutics (Hartford, CT)
- …Posting Title** Senior Compliance Analyst (Regulatory Compliants & Inquires) - Remote **Job Description** The Regulatory Inquiry & Complaints Senior Compliance ... Works independently to research and resolve regulatory inquiries/complaints related to claims , contracting and XXXX. Works directly with business partners across the… more
- Prime Therapeutics (Hartford, CT)
- …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
- Prime Therapeutics (Hartford, CT)
- …every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible for leading portions ... Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims , Member Materials, IT, etc.) to ensure effective collaboration,… more
- Zurich NA (Hartford, CT)
- …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 (Hartford, CT)
- …Office, AM - Oregon Virtual Office Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LB1 #LI- DIRECTOR ... prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims...for resume submission. Location(s): AM - Schaumburg, AM - Remote Work (US), AM - Dallas, AM - San… more
- HomeSafe Alliance (Hartford, CT)
- …with GHC pricing requirements and report actual performance monthly to the Director of International Operations (DIOps) + Verify and assess accuracy of transit ... risks of not meeting RDDs as directed by the Director of International Operations, for all shipments that may...International Operations, for all shipments that may create inconvenience claims for HomeSafe. Formats and data requirements to be… more
- Evolent Health (Hartford, CT)
- …Opportunities to work collaboratively with other Clinical Operation Leaders including our Director may also be available. **What You Will Be Doing:** + Reviewing ... prior authorization requests and/or relevant health care experience in claims or appeal & grievance is required. + Previous...while balancing a workload and prioritizing assignments in a remote environment. + The ability to connect to router… more
- Trustmark (Hartford, CT)
- …work on-site at our office in Lake Forest, IL for 3 days. Fully remote candidates are also welcome to apply.*_** Assess current state business processes and ... benefits products (ie, sales, implementation and enrollment, underwriting, billing, servicing, claims ) using DMAIC, PDCA, etc. methods. Develop the approach and… more