• Medical Director -- Claims

    Humana (Hartford, CT)
    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
    Humana (10/05/24)
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  • Medical Director - Florida

    Humana (Hartford, CT)
    …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 (10/04/24)
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  • Director , Product Management

    The Cigna Group (Bloomfield, CT)
    ** Director , Product Management - Digital Benefits Platform** As a Product Director in Evernorth's Digital team, you will be responsible for helping to build ... and capabilities. This role will report into the Product Strategy Senior Director and will be responsible for innovating, identifying opportunities and executing… more
    The Cigna Group (09/18/24)
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  • Medical Director - Grievances…

    Humana (Hartford, CT)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (09/17/24)
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  • Sr Director , Partner Operations

    Evolent Health (Hartford, CT)
    …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
    Evolent Health (10/03/24)
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  • Business Change Director (Quality Control…

    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 ... This high-performing individual contributor will be responsible for working with management to identify and implement varied projects, programs and plans that… more
    Elevance Health (10/04/24)
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  • Associate Director , Signal Detection…

    J&J Family of Companies (Hartford, CT)
    …safety data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...position is to lead the implementation of the Signal Management Group's aggregate surveillance strategies for proactive and systematic… more
    J&J Family of Companies (09/19/24)
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  • Director , Managed Care - Navista

    Cardinal Health (Hartford, CT)
    …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
    Cardinal Health (08/14/24)
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  • Director , Market Access Insights

    Sumitomo Pharma (Hartford, CT)
    …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
    Sumitomo Pharma (09/20/24)
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  • Associate Director , Global Labeling Lead…

    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 ... guidance. **How you will contribute:** With guidance from leadership: Management of Labeling Cross-Functional Teams + Independently leads Labeling cross-functional… more
    Takeda Pharmaceuticals (07/18/24)
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  • Business Analytics Director (Value based…

    The Cigna Group (Bloomfield, CT)
    **Summary** The Business Analytics Director will be responsible for strategizing and leading operational analytics, reporting and program implementation initiatives ... analytics, reporting implementation & innovation, market support analytics and financial management reporting etc. + Interact daily with the Affordability, Product,… more
    The Cigna Group (09/25/24)
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  • Director , Client Analytics - Healthcare…

    Evolent Health (Hartford, CT)
    …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
    Evolent Health (09/07/24)
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  • Individual Dental Business Development…

    The Cigna Group (Bloomfield, CT)
    The Individual Dental Strategy & Business Development Director will be responsible to maximize Cigna's performance by developing a comprehensive strategy for our ... goals through collaboration with business leaders and owners of relevant management processes, investments, and execution. + Champion strategic change initiatives,… more
    The Cigna Group (09/17/24)
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  • Associate Director , Data Science (ML…

    Evolent Health (Hartford, CT)
    …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
    Evolent Health (10/05/24)
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  • Category Management Lead Analyst - Claim…

    The Cigna Group (Bloomfield, CT)
    **Reports To** _Category Director , Pharmacy & Enterprise Operations_ **Role Summary** Accountable for sourcing activities and associated strategies across the Claim ... negotiation and procurement of the various products and functions associated with the Medical (and Dental) claim life cycle services which include, but are not… more
    The Cigna Group (09/27/24)
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  • Case Management Analyst (Every…

    The Cigna Group (Bloomfield, CT)
    …well as research and provide a written detailed clinical summary for the Plan Medical Director . + Determine whether additional pre service, appeal or grievance ... (Tuesday ALT Day).** + Must have experience in Medicare Appeals, Utilization Case Management or Compliance in Medicare Part C + Ability to differentiate different… more
    The Cigna Group (08/14/24)
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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Hartford, CT)
    **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
    HomeSafe Alliance (10/02/24)
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  • Manager Reporting & Analytics - REMOTE

    Prime Therapeutics (Hartford, CT)
    …+ 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
    Prime Therapeutics (10/05/24)
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  • Attending Physician

    Genesis Healthcare (Bristol, CT)
    …this position is $215000 / year. The Attending Physician works with the Center Medical Director to ensure that delivery of clinical services achieves the ... Attending Physician's Primary reporting relationship is to the AlignMed Partners Regional Medical Director . The Attending Physician is also accountable to both… more
    Genesis Healthcare (09/08/24)
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  • Manager, Clinical Operations

    Evolent Health (Hartford, CT)
    …leaders across the organization, training and development, provider relations, member services, claims management and our implementation team will also be ... plans and serves in a supporting role to the Director , Intake and Utilization Management Operations. +...population management or managed care/insurance or hospital medical management department setting may be substituted… more
    Evolent Health (10/03/24)
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