• Medical Director -- Claims

    Humana (Dover, DE)
    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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  • Business Change Director - Claims

    Elevance Health (Wilmington, DE)
    **Business Change Director - Claims /Payment Integrity Use-Case Lead** **Location:** This position will work a hybrid model (remote and office). Ideal candidates ... 50 miles of a PulsePoint location. The **Business Change Director - Claims /Payment Integrity Use-Case Lead** is responsible for...continue to improve on the process. The Business Change Director is responsible for working with management more
    Elevance Health (01/08/25)
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  • Medical Director - Florida

    Humana (Dover, DE)
    …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 (12/14/24)
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  • Medical Director - National Medicare…

    Humana (Dover, DE)
    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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  • Director , HIV Medical Affairs - NYC…

    Merck (Dover, DE)
    **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
    Merck (12/19/24)
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  • Director , Risk Management

    Western Digital (Dover, DE)
    …of action. + Develop, formulate and coordinate property and casualty insurance claims control function at all locations. + Continue review of existing safety, ... environment, loss prevention, employment and security programs as related to the management of risk or accidental loss. + Maintain historical record of all losses,… more
    Western Digital (12/27/24)
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  • Director of Care Management South-…

    Trinity Health (Wilmington, DE)
    …and Mercy Fitzgerald Hospital, members of Trinity Health Mid-Atlantic, is seeking experienced Director of Care Management South to join the Case Management ... team! **Schedule:** Full-time, 40hrs/wk, Monday-Friday day shift. The Director of Care Management is responsible for...-or- MSW degree + Ten years experience in Case Management or in Medical /Surgical Acute Care setting;… more
    Trinity Health (01/01/25)
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  • Medicare Grievances and Appeals Corporate…

    Humana (Dover, DE)
    …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
    Humana (01/07/25)
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  • Oncology Regional Medical Scientific…

    Merck (Dover, DE)
    …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
    Merck (01/10/25)
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  • Director , Medicaid Trend Mitigation…

    Humana (Dover, DE)
    …functions strategy. + Establishes and oversees Medicaid segment trend mitigation strategy ( claims and revenue management ) + Researches industry trends and ... part of our caring community and help us put health first** The Director , Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and… more
    Humana (01/08/25)
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  • Director of International, Global Household…

    HomeSafe Alliance (Newark, DE)
    **Title:** Director of International, Global Household Goods Moving Services **_HomeSafe Alliance_** is the single global household goods movement manager of over ... the Role** HomeSafe Alliance is seeking a highly skilled and motivated Director of International, Household Goods Moving Services to drive optimization and improve… more
    HomeSafe Alliance (12/21/24)
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  • Director Healthcare Economics & Trend…

    Baylor Scott & White Health (Dover, DE)
    claims data to uncover trends and assist in managing and understanding incurred medical and pharmacy cost. - The Director will design, develop, and support ... **Position Overview:** Reporting to the VP, Value-based Care Analytics, the Director of Healthcare Economics and Trend Analytics will support the Baylor Scott &… more
    Baylor Scott & White Health (12/21/24)
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  • Actuarial Director , Medicaid Trend…

    Humana (Dover, DE)
    …our caring community and help us put health first** The Actuarial Director , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to ... short, medium and long-term financial and competitive position. The Director , Actuarial Analytics/Forecasting requires an in-depth understanding of how organization… more
    Humana (01/03/25)
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  • Associate Director , Global Labeling Lead…

    Takeda Pharmaceuticals (Dover, DE)
    …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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  • Operations Supervisor - Move Management

    HomeSafe Alliance (Newark, DE)
    **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 (01/01/25)
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  • Sales Administrator

    Fujifilm (Dover, DE)
    …Sales Administrator for Latin America and the Caribbean will report to the Director of Sales for ID/Optical Devices/ EID. The primary responsibility of this position ... be to support sales for Latin America and Caribbean accounts currently under management by FNAC. Achieve the division sales plan, provide weekly and monthly detail… more
    Fujifilm (01/07/25)
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  • Principal Client Solution Architect - State…

    Mathematica (Dover, DE)
    …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
    Mathematica (01/04/25)
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  • Cloud Solutions Architect Leader

    Sedgwick (Dover, DE)
    …and goals for cloud-based infrastructure services in conjunction with senior IT management . The Director Infrastructure Services - Cloud designs and drives ... This role is responsible for the overall planning and management of the company data center and corporate IT...benefits package is offered including but not limited to, medical , dental, vision, 401k and matching, PTO, disability and… more
    Sedgwick (10/18/24)
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