• Senior Director , Claims

    Banner Health (Phoenix, AZ)
    …and a minimum of five to seven years medical professional liability management experience, either as in-house claims professional or outside counsel. Must ... Mgmt **Work Shift:** Day **Job Category:** Legal The **Senior Director , Claims & Litigation Counsel** will provide...leadership experience with healthcare risk management , quality management , in house liability claims management more
    Banner Health (03/04/25)
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  • Claims Manager - Liability - REMOTE

    Ryder System (Phoenix, AZ)
    …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 (Phoenix, AZ)
    …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 (Phoenix, AZ)
    …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 (Phoenix, AZ)
    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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  • Senior Director , Clinical Risk…

    Banner Health (Phoenix, AZ)
    …professional clinical degree and experience with healthcare professional liability claims management . Additional related education and/or experience preferred. ... Rel **Work Shift:** Day **Job Category:** Risk, Quality and Safety The **Senior Director , Clinical Risk Management & Patient Relations** will provide strategic… more
    Banner Health (03/04/25)
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  • Remote Medical Director - Arizona

    Centene Corporation (Phoenix, AZ)
    …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
    Centene Corporation (01/25/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (Phoenix, AZ)
    …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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  • Director , Provider Contracting Network…

    The Cigna Group (Scottsdale, AZ)
    …channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management . Credentialing, Legal, Medical ... with Providers AND several days work at Home_** The ** Director , Provider Contracting Network Management ** serves as...position. + Creates and manages initiatives that improve total medical cost and quality. + Drives change with external… more
    The Cigna Group (02/20/25)
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  • Hematology Regional Medical Scientific…

    Merck (Phoenix, AZ)
    **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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  • Senior Director of Underwriting - REMOTE

    Prime Therapeutics (Phoenix, AZ)
    …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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  • Director , Risk Adjustment

    Banner Health (Mesa, AZ)
    …innovative employment options by offering remote and hybrid work settings. As a Director , Risk Adjustment Health Plan, you will call upon your extensive experience ... in Medical Coding and Leadership daily. You will be responsible...In addition, this position may be eligible for our Management Incentive Program as part of your Total Rewards… more
    Banner Health (03/19/25)
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  • Director , Special Investigations Unit,…

    Molina Healthcare (Scottsdale, AZ)
    …* 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 (Phoenix, AZ)
    …+ 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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  • Commercial Project Manager

    Stantec (Chandler, AZ)
    …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... context of the communities we serve, we provide planning, engineering, and infrastructure management services that fit the needs of our clients and improve the… more
    Stantec (03/14/25)
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  • Manager, Provider Contracts

    Molina Healthcare (Mesa, AZ)
    …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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  • Legal Counsel, Regulatory

    Alliance Defending Freedom (Scottsdale, AZ)
    …Division Team. In this role, you will report to the Senior Counsel, Director of Regulatory Practice. Legal Counsel is an experienced attorney capable of undertaking ... civil actions with emphasis on federal administrative law, structural constitutional claims , Administrative Procedure Act claims , First Amendment law, and… more
    Alliance Defending Freedom (03/06/25)
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  • Manager-Performance Strategy (Amex Assurance)

    American Express (Phoenix, AZ)
    …related change management efforts. The manager will report to the Director of Partner Management and Operations Strategy. **Responsibilities:** + Work with ... as our proprietary teams. Additionally, the team is responsible for the management and regulatory aspects of Amex's wholly owned subsidiary, Amex Assurance Company.… more
    American Express (03/12/25)
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  • Sr. Dir, Professional Affairs Skin Health

    Colgate-Palmolive (Scottsdale, AZ)
    …for a Director of Professional Affairs to strategize and develop medical strategies that will support our Skin Health products and initiatives. This person ... goals. Together, let's build a brighter, healthier future for all. **Title: Director , Professional Affairs - Skin Health** **Location: Scottsdale, AZ** **Reports To:… more
    Colgate-Palmolive (02/25/25)
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  • District Manager, Neuroscience Sales, Southwest

    Intra-Cellular Therapies, Inc (Phoenix, AZ)
    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
    Intra-Cellular Therapies, Inc (03/04/25)
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