• Claims Manager - Liability - REMOTE

    Ryder System (Nashville, TN)
    …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
    Ryder System (02/25/25)
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  • Sr Claims Supervisor

    HCA Healthcare (Nashville, TN)
    …department and company strategy and philosophy of proactive, efficient and effective claims management . + Continuous and appropriate documentation within, and ... and administration of special projects as assigned by the Claims Director , HCI President and VP of...industry trends, changes in laws and rules affecting liability claims management decisions. **People** + Work collaboratively… more
    HCA Healthcare (02/06/25)
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  • Medicare Benefits Standards & Guidance Lead…

    CVS Health (Nashville, TN)
    …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
    CVS Health (03/14/25)
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  • Medical Director - Medicaid N.…

    Humana (Nashville, TN)
    …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 (03/11/25)
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  • Medical Director - National Medicare…

    Humana (Nashville, TN)
    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 (03/11/25)
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  • Market Director of Utilization…

    Ascension Health (Nashville, TN)
    …market. Must be located with in the TN market. We're looking for an experienced Director of Utilization Management to join our team! In this pivotal role, you'll ... optimize patient care and partner with the National Senior Director of UM to align on organizational goals. Ready...within the insurance plan. + Ensure integration of utilization management functions with network strategy and claims more
    Ascension Health (01/24/25)
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  • Hematology Regional Medical Scientific…

    Merck (Nashville, TN)
    **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
    Merck (03/04/25)
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  • Patient Safety Director

    HCA Healthcare (Smyrna, TN)
    …team of daring managers who care without reservations or limits? Our TriStar StoneCrest Medical Center team is looking for a Patient Safety Director . HCA ... over the course of three years. **Benefits** TriStar StoneCrest Medical Center offers a total rewards package that supports...across the country? Apply today to our Patient Safety Director and be a part of the innovation of… more
    HCA Healthcare (03/15/25)
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  • Accounting Director

    Wellpath (Nashville, TN)
    …and documentation of business cycle processes to maintain compliance. + Collaborate with claims , risk management , and legal teams to ensure accurate financial ... * Growth and training **Perks and Benefits** In addition to comprehensive benefits including medical , dental, vision, paid time off, and 401k, we foster a work, life… more
    Wellpath (03/14/25)
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  • Senior Director of Underwriting - REMOTE

    Prime Therapeutics (Nashville, TN)
    …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
    Prime Therapeutics (03/11/25)
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  • Marketing Analytics Director

    Sedgwick (Nashville, TN)
    …to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Marketing Analytics Director **PRIMARY PURPOSE OF THE ROLE:** The Marketing Analytics Director ... growth opportunities + A diverse and comprehensive benefits offering including medical , dental vision, 401K, PTO and more Work environment requirements for… more
    Sedgwick (03/04/25)
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  • Executive Director , Strategic Partnerships

    Trustmark (Nashville, TN)
    …+ 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
    Trustmark (02/19/25)
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  • Billing Specialist II - Workers Comp (Remote)

    Community Health Systems (Franklin, TN)
    …Billing/Coding preferred + 2-4 years of experience in medical billing, insurance claims processing, or revenue cycle management required + 1-3 years in ... is responsible for managing complex billing functions, ensuring timely and accurate claims processing, and resolving issues related to insurance payments and account… more
    Community Health Systems (03/13/25)
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  • Medical Staff Privileging Coordinator

    Intermountain Health (Nashville, TN)
    …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
    Intermountain Health (03/13/25)
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  • Denial Management Specialist - REMOTE

    Community Health Systems (Antioch, TN)
    **Job Summary** The Denials Management Specialist is responsible for working assigned denials and appeals claims by communicating with all necessary departments ... 1-3 years experience in healthcare setting with experience in medical terminology required + 1-3 years Experience in revenue...part of the application or hiring process, contact the director of Human Resources at the facility to which… more
    Community Health Systems (02/21/25)
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  • Clinical Letter Writer (Part-time) - RN, LVN/LPN…

    Evolent (Nashville, TN)
    …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
    Evolent (03/11/25)
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  • Billing Senior Manager

    HCA Healthcare (Nashville, TN)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
    HCA Healthcare (01/23/25)
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  • Payer Engagement Sr Analyst

    HCA Healthcare (Brentwood, TN)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and… more
    HCA Healthcare (01/30/25)
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  • Human Resources Manager OEM Task Force

    Aimbridge Hospitality (Nashville, TN)
    Job Summary The Human Resource Manager will report directly to the Director of Human Resources or General Manager (property specific). As a member of the property ... with federal state and local regulations and Aimbridge Hospitality operating procedures. Management -level associates are expected to work as much of each workday as… more
    Aimbridge Hospitality (02/14/25)
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  • Payment Compliance Analyst (Remote)

    Community Health Systems (Franklin, TN)
    …revenue cycle processes + Interpret contract reimbursement and provide feedback to management staff as required + Manage underpayment appeals, account follow-up and ... collaboratively + Review contract validation, updates and interpretation + Resolve underpaid claims in an effective and timely fashion + Review payer policies for… more
    Community Health Systems (03/04/25)
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