• Medical Director -- Claims

    Humana (Jackson, MS)
    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 (10/29/24)
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  • Medical Director - Florida

    Humana (Jackson, MS)
    …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 (12/14/24)
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  • Reviewing Medical Director

    Conviva (Jackson, MS)
    …community and help us put health first** The Medical Director relies on medical background and reviews health claims . The Medical Director work ... Physician Leadership in Population Health Strategy at Primary Care Organization. The Medical Director conducts Utilization Management of the care received by… more
    Conviva (12/11/24)
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  • Medical Director - National Medicare…

    Humana (Jackson, MS)
    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
    Humana (11/08/24)
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  • Director , Medical Affairs - NYC…

    Merck (Jackson, MS)
    **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
    Merck (12/19/24)
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  • Corporate Medical Director

    Humana (Jackson, MS)
    …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
    Humana (11/27/24)
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  • Director of International, Global Household…

    HomeSafe Alliance (Jackson, MS)
    **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
    HomeSafe Alliance (12/21/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Jackson, MS)
    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, he Director of Healthcare Economics and Trend Analytics will support the Baylor Scott & White… more
    Baylor Scott & White Health (12/21/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Jackson, MS)
    …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 (10/16/24)
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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Jackson, MS)
    **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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  • Coordinator, Intake Utilization Management

    Evolent (Jackson, MS)
    …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
    Evolent (12/04/24)
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  • Coordinator, Utilization Management

    Evolent (Jackson, MS)
    …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
    Evolent (12/24/24)
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  • Data Visualization Consultant - Remote

    Prime Therapeutics (Jackson, MS)
    …with data consolidation and modeling + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... **Responsibilities** + Under general supervision, analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to… more
    Prime Therapeutics (12/19/24)
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  • Manager, Provider Contracts (Remote in MS only)

    Molina Healthcare (Jackson, MS)
    …and JOCs. Entail heavy negotiations. Maintains critical Complex provider information on claims and provider databases. Synchronizes data among multiple claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Job Duties** Manages the Plan's Provider Contracting… more
    Molina Healthcare (10/10/24)
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  • Manager, Reporting & Analytics - Remote

    Prime Therapeutics (Jackson, MS)
    …+ 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 (12/18/24)
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  • AVP, Human Resources Business Partner

    SitusAMC (Jackson, MS)
    …team! This role is responsible for aligning business goals with employees and management . The position should anticipate HR needs in a proactive manner and ... communicate these requirements and potential solutions to the management team. This position is the HR point of contact for management and employees for their… more
    SitusAMC (12/19/24)
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  • Manager, Provider Contracting - Arkansas, Alabama…

    The Cigna Group (Jackson, MS)
    …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical ... Must reside in either: Arkansas, Alabama or Mississippi,_** The **Manager, Network Management ** serves as an integral member of the Provider Contracting Team and… more
    The Cigna Group (11/05/24)
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  • Senior Compliance Specialist

    Fujifilm (Jackson, MS)
    …limited management oversight. The position will report to the Director of Corporate Compliance. **Duties and responsibilities** + Develop and implement elements ... needs of healthcare across prevention, diagnosis, and treatment. Fujifilm's medical imaging portfolio includes solutions for digital radiography, mammography,… more
    Fujifilm (10/09/24)
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  • Sr. Applied Stars and Quality Analytics Analyst

    Prime Therapeutics (Jackson, MS)
    …) experience + Experience conducting complex analysis on large sets of pharmacy, claims , medical , and/or financial data + Basic to intermediate SAS coding ... adjust focus **Reporting Structure** + Reports to Manager or Director in the Network Management , Consulting Analytics...to Manager or Director in the Network Management , Consulting Analytics or Operations & Planning department Potential… more
    Prime Therapeutics (12/24/24)
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