• Claims Manager - Liability - REMOTE

    Ryder System (Madison, WI)
    …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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  • Medical Director - Medicaid N.…

    Humana (Madison, WI)
    …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 - Care Plus…

    Humana (Madison, WI)
    …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 (03/18/25)
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  • Medical Director - National Medicare…

    Humana (Madison, WI)
    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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  • Medical Director (Marketplace)

    Molina Healthcare (Madison, WI)
    …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
    Molina Healthcare (02/06/25)
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  • Business Development Director

    Sedgwick (Madison, WI)
    …of education and experience required to include five (5) years of relationship building in the claims management or risk management . + Must reside in one of ... Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Business Development Director **PRIMARY PURPOSE OF THE ROLE:** To expand and enhance the… more
    Sedgwick (03/15/25)
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  • Senior Director of Underwriting - REMOTE

    Prime Therapeutics (Madison, WI)
    …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 (Madison, WI)
    …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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  • Director , Special Investigations Unit,…

    Molina Healthcare (Madison, WI)
    …* 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
    Molina Healthcare (03/15/25)
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  • Executive Director , Strategic Partnerships

    Trustmark (Madison, WI)
    …+ 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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  • Manager, Provider Contracts

    Molina Healthcare (Madison, WI)
    …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
    Molina Healthcare (03/04/25)
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  • Enterprise Fraud Data Strategy Analyst

    UMB Bank (Madison, WI)
    …across all payment channels. Will work with the Enterprise Fraud Prevention and Claims teams to provide data to help identify emerging fraud trends and UMB's ... concert with the Enterprise Fraud Prevention and Enterprise Fraud Claims teams to identify fraud exposure and make necessary...to fulfill overall business needs and expectations of the Director of Enterprise Fraud Operations and the bank's senior… more
    UMB Bank (03/19/25)
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  • Manager, Ethics and Compliance

    Cardinal Health (Madison, WI)
    …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
    Cardinal Health (03/18/25)
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