- Humana (Salt Lake City, UT)
- … 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
- University of Utah Health (Murray, UT)
- …years of experience collecting, organizing and maintaining health insurance and processing medical claims , enrollment, and familiarity with medical coding, ... that are integral to our mission. EO/AA_ + This position is responsible for auditing claims and customer service calls for UUHP. + The Claims and Customer… more
- Humana (Salt Lake City, UT)
- …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
- Merck (Salt Lake City, UT)
- **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
- Molina Healthcare (Orem, UT)
- **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. +...claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees… more
- Humana (Salt Lake City, UT)
- …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
- Merck (Salt Lake City, UT)
- …needs to support collaboration to further differentiate our portfolio. The Oncology Regional Medical Scientific Director , RMSD, is a credentialed (ie, MD, PhD, ... **Job Description** Our Medical Affairs team advances patient care by engaging...and scientific community. Scientific exchange does not include promotional claims about any drug, vaccine or biologic product. RMSDs… more
- Cardinal Health (Salt Lake City, UT)
- …and delivers human resource programs and policies, including recruitment, talent management , diversity and inclusion, compensation and benefits, among others. This ... **_Job Summary_** We are seeking an experienced and strategic Director of US Benefits to lead and oversee the...Benefits to lead and oversee the design, implementation, and management of employee benefit programs. This role will be… more
- United Therapeutics (Salt Lake City, UT)
- …orphan diseases. **How you'll contribute** The Associate Analytics, Insights and Operations Director , Market Access will lead data support across all functions of ... Compliance, Legal, Information Technology, Sales & Marketing Operations, Finance, and Medical Affairs / HEOR. Additionally, this role will support special pricing… more
- Wells Fargo (Salt Lake City, UT)
- …small business fraud activity + Collaborate with and influence immediate fraud and claims management colleagues, card partners, and branch network partners as ... Fargo is seeking a Card and Branch Fraud Prevention Director to report to the Director of...allocation of people and financial resources for Fraud and Claims Management + Develop and guide a… more
- Merck (Salt Lake City, UT)
- …deliver measurable impact in commercial pharma landscape. + Knowledge in mining medical claims /EMR, social media, etc. data with a strategic/inquisitive mindset ... **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater… more
- Takeda Pharmaceuticals (Salt Lake City, UT)
- …plasma-derived therapies for patients with immunologic, hematologic, and other complex diseases. The Director , Global Labeling Strategy Lead is a key role in the PDT ... new TLP, CCDS, USPI and EU SmPC. **How you will contribute:** ** Management of Labeling Cross-Functional Teams** + Leads Labeling cross-functional teams providing… more
- Takeda Pharmaceuticals (Salt Lake City, UT)
- …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
- Molina Healthcare (Orem, UT)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... (SIU) to oversee the special investigations unit vendor outlier analytics and case management system, training and implementation. Serves as a backup for the AVP of… more
- Zurich NA (Salt Lake City, UT)
- …Member of the Bar + Extensive experience in and in-depth knowledge of Casualty claims management + Highly detail-oriented with a strong focus on accuracy + ... AVP, Medical Bill Review Litigation 119916 Zurich Insurance is...and other legal filings + Maintain accurate and up-to-date claims documentation, ensuring compliance with best practices for high-complexity… more
- University of Utah Health (Salt Lake City, UT)
- …and 25+ facilities across Utah. This coordinator role will work with reports/ claims data, assist with appeals and grievances, and ideally requires experience with ... health plans and claims . Additionally, the coordinator will support and collaborate closely...and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. **Responsibilities** + Provides… more
- University of Utah (Salt Lake City, UT)
- …1. Contacts patients and insurance companies for payments requests, overdue payments, denied claims and arranges payment plans. 2. Enters medical codes from ... billing process from eligibility to completion of payment process. Provides medical billing and collection processes by verifying eligibility and benefits, obtaining… more
- University of Utah (Salt Lake City, UT)
- …managers/case workers, and patients, regarding the status of funding. Works with Medical Director , physicians, and billing offices to determine cost estimates ... Seldom: Bending, reaching overhead. **Minimum Qualifications** Four years experience with medical accounts receivable, insurance claims , or equivalency (one year… more
- Mathematica (Salt Lake City, UT)
- …or APCD claims data; EHR and/or HIE data; healthcare informatics; medical coding). * Ability to describe difficult technical problems and solutions to a ... data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and… more
- University of Utah Health (Salt Lake City, UT)
- …Employee Relations or equivalency. + Bachelor's degree in Human Resources Management , Business Administration or a related field. **Corporate Overview:** The ... hospitals and eleven clinics provide excellence in our comprehensive services, medical advancement, and overall patient outcomes. _As a patient-focused organization,… more