- Ryder System (Des Moines, IA)
- …of assigned staff. Assists Director with other staff as directed. Work with Director and other management team to develop tactics and strategies to achieve ... staff. Handles commercial lines bodily injury and property damage claims as well as insurance and contractual coverage issues....annual metrics and other KPI's + Participates with the Director in the selection and management of… more
- Humana (Des Moines, IA)
- …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Lead Medical Director - North Central Medicaid Markets. The Medical Director conducts Utilization Management of the care received by members in the… more
- Humana (Des Moines, IA)
- … 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
- Molina Healthcare (Des Moines, IA)
- …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
- Merck (Des Moines, IA)
- **Job Description** The Hematology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, or PharmD) therapeutic and disease expert who ... engages in scientific exchange with leaders in the external medical and scientific community. Scientific exchange does not include promotional claims about any… more
- Mass Markets (IA)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... the industry. We are seeking a seasoned and driven Director of Sales to join our team. The ideal...Exceptional attention to detail. + Strong organizational and time management skills to thrive in a fast-paced environment. +… more
- Prime Therapeutics (Des Moines, IA)
- …our passion and drives every decision we make. **Job Posting Title** Senior Director of Underwriting - REMOTE **Job Description** The Sr. Director Underwriting ... for prospective clients and new customer acquisitions. **Responsibilities** + Analyze claims data and develop cost-of-care projections for existing customer renewals… more
- Black Hills Energy (Council Bluffs, IA)
- …exams, and PPE. * Support the Insurance and other Departments for the effective management of Worker's Compensation and disability claims , and Human Resources in ... Director of Corporate Safety Location: Council Bluffs, IA,...OSHA and MSHA, to include employee training, facilities, records management , etc. * Foster communication of best practices, accident… more
- Molina Healthcare (Cedar Rapids, IA)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... from root cause analysis through implementation * Oversees vendor FWA case management including tracking on schemes, coordinating internal efforts with vendor to… more
- Mass Markets (IA)
- …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... will be a results-driven leader with extensive experience inBPO operations management , strong problem-solving abilities, and a commitment to customer satisfaction.… more
- Trustmark (Des Moines, IA)
- …+ Collaborate with the sales leadership teams of VP of Sales & Client Management , Senior Directors' Sales, and the whole sales team to maximize opportunities. + ... accounting of activities and sales. + Collaborate with and support the Client Management team to assure persistency goals are being achieved. + Review national… more
- CVS Health (Des Moines, IA)
- …and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense ... communication, both internally and externally to enhance effectiveness of medical management services (eg, health care providers,...+ May assist in the research and resolution of claims payment issues + Supports the administration of the… more
- AON (IA)
- …risk management solutions and consultative services. Reports to PrinRei's Assistant Director of Risk Management . Some travel may be required. Role ... tools for senior management and operating personnel describing risk management policies, programs, loss control initiatives and claims history. +… more
- Intermountain Health (Des Moines, IA)
- …on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health ... assistant- + Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within four (4) years of… more
- Access Dubuque (Dubuque, IA)
- …PURPOSE OF THE ROLE** : Analyzes reported leave requests including Family Medical Leave (FMLA), unpaid state, military and company-specific, to make determinations ... on client plans, state and federal regulations. Ensures that on-going claim management is within company service standards and industry best practices. **ARE YOU… more
- Molina Healthcare (Cedar Rapids, IA)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the … more
- Aveanna Healthcare (Sioux City, IA)
- …and certifications) o Creating and providing monthly evaluation and skills report to Director (s) o Coordinate with Corporate Risk Management and Leave of Absence ... plans for new clients and communicates information to location management - Manages Pending Report to keep total in...Specialists on all worker compensation claims and return to work coordination activities o Coordinate… more
- Trinity Health (Davenport, IA)
- …and government entities. The Risk Specialist reports directly to the MercyOne RHM Director of Accreditation and Risk Management . ESSENTIAL FUNCTIONS 1. Knows, ... investigating claims . 14. Participates in TH and MercyOne risk management related meetings and affinity groups with implementation of identified initiatives. 15.… more
- Evolent (Des Moines, IA)
- …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... necessary/required. + Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as… more
- Access Dubuque (Dubuque, IA)
- …and Content Strategist Cottingham & Butler/ SISCO Project Specialist Clarke University Claims Processing Representative Grand River Medical Group **Share this ... engagement efforts by overseeing gift entry, acknowledgement, reporting, and data management . The specialist will collaborate with the advancement team, finance… more