- Ryder System (Frankfort, KY)
- …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
- CVS Health (Louisville, KY)
- …during the plan year. The **Medicare** **Benefits Standards & Guidance Lead Director ** ensures accountability for the implementation, management , and maintenance ... Employer Groups. The **Medicare** **Benefits Standards & Guidance Lead Director ** acts as the point of contact to our...such as Benefit & Product Strategy, Benefits & Product claims configuration, Medicare Service Operations (MSO), Medical … more
- Humana (Frankfort, KY)
- …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 (Frankfort, KY)
- …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 (Frankfort, KY)
- … 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
- Centene Corporation (Frankfort, KY)
- …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. + ... 28 million members as a clinical professional on our Medical Management /Health Services team. Centene is a...performance improvement initiatives for capitated providers. + Assists Chief Medical Director in planning and establishing goals… more
- Molina Healthcare (Louisville, KY)
- …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 (Frankfort, KY)
- **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 (KY)
- …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 (Frankfort, KY)
- …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
- Molina Healthcare (Owensboro, KY)
- …* 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 (KY)
- …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 (Frankfort, KY)
- …+ 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
- Molina Healthcare (Bowling Green, KY)
- …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
- CVS Health (Frankfort, KY)
- …team in an Sr. Analyst role. This is a client facing project management / auditor position that is responsible for coordinating, managing, tracking, reviewing, ... of exceptions identified during the audit process, specifically related to pharmacy claims and manufacturer rebates. This includes having a working knowledge base… more
- Intra-Cellular Therapies, Inc (Lexington, KY)
- Benefits Offered 401K, Dental, Life, Medical , Vision Employment Type Full-Time "We deliver innovative treatments to improve the lives of individuals suffering from ... by high impact resource allocation decisions. DMs will assume ownership and the management of a wide range of customer interactions as well as accountability for… more
- Cardinal Health (Frankfort, KY)
- …on policies. **_Manager, Ethics and Compliance_** Reporting to the Compliance Director , this position is responsible for supporting the programmatic requirements for ... focus include: compliance training, policy development, exclusion screening tracking, management of investigations and development of programmatic presentation materials.… more