• Medical Director -- Claims

    Humana (Phoenix, AZ)
    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
    Humana (10/29/24)
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  • Executive 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 **Executive Director , Claims & Litigation Counsel** will provide...leadership experience with healthcare risk management , quality management , in house liability claims management more
    Banner Health (09/26/24)
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  • Claims Litigation Manager Senior…

    USAA (Phoenix, AZ)
    …part of what makes us so special! **The Opportunity** We are seeking a dedicated Claims Litigation Case Manager Senior. This position is a hybrid work type and can ... resource for colleagues with less experience. + Applies advanced knowledge of claims litigation processes. + Proactively manages litigation and acts as liaison with… more
    USAA (10/17/24)
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  • Claims Manager

    Crawford & Company (Phoenix, AZ)
    …claim adjusters and other staff and oversee the analysis, review and validation of claims under the direction of the Managing Director . Ensures processes and ... years of experience as an Adjuster, Adjuster in Charge, Claims Supervisor or Claims Manager. + Previous...appropriate license(s) as required by the state(s) at the adjuster/supervisory/ management level. + Must possess a valid driver's license.… more
    Crawford & Company (11/13/24)
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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 (11/08/24)
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  • Medical Director - Medicare

    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 (11/02/24)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Phoenix, AZ)
    …us put health first** The Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate ... Medical Director works on problems of diverse scope and complexity...focused on continuously improving consumer experiences **Preferred Qualifications** + Medical utilization management experience, + working with… more
    Humana (10/29/24)
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  • Lead Director , Network Management

    CVS Health (Phoenix, AZ)
    …health care more personal, convenient and affordable. **Position Summary** The Lead Director of value based contracting and business development is responsible for ... annual bid process. The position will work closely with the Engagement Management resources responsible for optimizing performance of our VBC agreements to ensure… more
    CVS Health (10/26/24)
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  • Director , Network Operations

    Sedgwick (Phoenix, AZ)
    …+ Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director , Network Operations **PRIMARY PURPOSE** : To be responsible for the… more
    Sedgwick (11/16/24)
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  • Procurement Director

    Microsoft Corporation (Phoenix, AZ)
    …of those assets. We are looking to fill the critical role of Procurement Director for the Americas region. In alignment with our Microsoft values, we are committed ... and compliance through supplier selection, supplier selection and award, and contract management . ** Procurement + Leads a team of leaders who create, align,… more
    Microsoft Corporation (11/08/24)
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  • Associate Director , Access and Patient…

    Cardinal Health (Phoenix, AZ)
    …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
    Cardinal Health (11/14/24)
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  • Client Services Director - Casualty | CST…

    Sedgwick (Phoenix, AZ)
    …rounding ability + Strong understanding of workers compensation, liability and disability claims management + In-depth knowledge of client servicing + Ability ... Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Client Services Director - Casualty | CST & EST Time Zones...EST Time Zones **PRIMARY PURPOSE** : To determine account management strategies related to client service plans; to be… more
    Sedgwick (11/12/24)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Phoenix, AZ)
    …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
    Takeda Pharmaceuticals (10/16/24)
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  • Lead Director , Operations - CVS…

    CVS Health (Phoenix, AZ)
    …health care more personal, convenient and affordable. **Position Summary:** **The Lead Director , Operations (hiring for two positions)** plays a key role by leading ... executive, providers, and administrative staff. + Relationship building + Medical cost, risk, and quality analysis + Transforming data...in a care delivery setting, population health and care management + 5+ years of strong Medicare and clinical… more
    CVS Health (10/27/24)
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  • Enterprise Internal Fraud Detection Analytics…

    Wells Fargo (Chandler, AZ)
    …Analytics Team. A part of the Chief Operating Office under Fraud and Claims Operations, the team provides analytic support and internal fraud detection capabilities ... including, but not limited to, Model Risk, Fraud Risk and Allegations Management . This position will have direct interaction/engagement with independent risk … more
    Wells Fargo (11/16/24)
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  • Enterprise Internal Fraud Senior Lead Analytics…

    Wells Fargo (Chandler, AZ)
    …Analytics Team. As part of the Chief Operating Office under Fraud and Claims Management , the team provides analytic support and internal fraud detection ... education **Desired Qualifications:** + 5+ years project and program management experience + Demonstrable experience in process and procedure documentation… more
    Wells Fargo (11/16/24)
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  • Enterprise Internal Fraud Senior Lead Analytics…

    Wells Fargo (Chandler, AZ)
    …Analytics Team. A part of the Chief Operating Office under Fraud and Claims Operations, the team provides analytic support and internal fraud detection capabilities ... + 3+ years of Internal Fraud, Fraud Detection, Anti-Money Laundering, or Conduct Management experience **Desired Qualifications:** + 7+ years of SQL experience + 7+… more
    Wells Fargo (11/16/24)
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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Phoenix, AZ)
    **Title:** Operations Supervisor - Move Management (International Alaska) **_HomeSafe Alliance_** is the single global household goods movement manager of over ... directly or through PPM options + Provide consolidated oversight and management of coordinators under supervision + Monitor international operations performing… more
    HomeSafe Alliance (10/02/24)
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  • Coordinator, Intake Utilization Management

    Evolent Health (Phoenix, AZ)
    …Stay for the culture. **What You'll Be Doing:** The **Coordinator, Intake Utilization Management ** at Evolent will serve as a point of contact for processing ... medical treatment requests in accordance with departmental policies, regulatory...contractual agreements. **Collaboration Opportunities** : The Coordinator, Intake Utilization Management reports directly to the Manager, Intake Utilization … more
    Evolent Health (11/12/24)
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  • Human Resources Business Partner

    GNC (Phoenix, AZ)
    …such as succession planning, career path development, and performance management . Leading talent assessments and facilitating onboarding and offboarding processes ... are integral components of your role. Reporting to the Director of Human Resources, you will serve as a...will serve as a business partner to the Division Management Team while addressing a wide array of associate… more
    GNC (11/07/24)
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