• Claims Manager - Liability - REMOTE

    Ryder System (Jefferson City, MO)
    …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 (Jefferson City, MO)
    …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 - National Medicare…

    Humana (Jefferson City, MO)
    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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  • Remote Marketplace Medical Director

    Centene Corporation (Jefferson City, MO)
    …the Chief Medical Director to direct and coordinate the medical management , quality improvement and credentialing functions for the business unit. Those ... 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 (03/07/25)
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  • Hematology Regional Medical Scientific…

    Merck (Jefferson City, MO)
    **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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  • Field Medical Outcomes, Director

    Pfizer (Jefferson City, MO)
    …opportunities for improving patient care, closing quality gaps, and addressing population health management . + Serve as the Field Medical Outcomes lead for ... field-based medical /outcomes role. + Experience analyzing health care data ( claims , electronic health records, other health care data). + Expertise in Clinical… more
    Pfizer (03/09/25)
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  • Medical Director

    Blue KC (MO)
    …Summary:** Provides medical leadership and physician advice for the Medical Management function. Additionally, provides leadership and advice to other ... development for a major program or functional area within Medical Management , eg, medical policy,...providers in the community. + Reviews customer service and claims inquiries. **Minimum Qualifications** + MD or DO degree… more
    Blue KC (01/17/25)
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  • Director of Sales

    Mass Markets (MO)
    …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... the industry. We are seeking a seasoned and driven Director of Sales to join our team. The ideal...Exceptional attention to detail. + Strong organizational and time management skills to thrive in a fast-paced environment. +… more
    Mass Markets (01/24/25)
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  • Senior Director of Underwriting - REMOTE

    Prime Therapeutics (Jefferson City, MO)
    …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 of Operations

    Mass Markets (MO)
    …Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, ... will be a results-driven leader with extensive experience inBPO operations management , strong problem-solving abilities, and a commitment to customer satisfaction.… more
    Mass Markets (03/13/25)
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  • Executive Director , Strategic Partnerships

    Trustmark (Jefferson City, MO)
    …+ 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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  • Clinical Nurse Case & Disease Management

    Blue KC (MO)
    …in FACETS UM system in accord with UM concurrent review guidelines. Consults with Medical Director on cases outside medical policy, notifies providers and ... accord with medical policy. Opens case and follows NCQA case management standards. Documents transplant authorization, issues authorization letters, and follows… more
    Blue KC (02/19/25)
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  • Human Resources Generalist

    Select Medical (O'Fallon, MO)
    …**Position Overview** The HR Coordinator assists the department by providing daily management of the Human Resources function. They will perform confidential and ... Screens all incoming correspondence, and, in the absence of the HR Manager/ Director refers materials requiring immediate attention to the appropriate department +… more
    Select Medical (02/12/25)
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  • Medical Staff Privileging Coordinator

    Intermountain Health (Jefferson City, MO)
    …on-going credentialing / privileging process and other administrative functions for the Medical Staff, Medical Director , Administration, and Allied Health ... assistant- + Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within four (4) years of… more
    Intermountain Health (03/13/25)
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  • Manager, Financial Reporting

    Spire Energy (St. Louis, MO)
    …and support the calculation of specific management estimates including the analyses of medical accruals, legal and environmental claims as claims well as ... timely reporting of the Company's financial data for internal and support the Director of External Reporting for external reporting purposes. This job is also… more
    Spire Energy (02/15/25)
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  • Security Technician *Thunder Ridge Nature Arena

    ASM Global (Ridgedale, MO)
    …risk and liability of all venue security, ingress and egress processes and crowd management with the Director and GM. Essential Duties and Responsibilities + ... POSITION: Security Technician DEPARTMENT: Security REPORTS TO: Director of Venue Security Operations FLSA STATUS: Non-Exempt LEGENDS & ASM GLOBAL Two powerhouse… more
    ASM Global (03/04/25)
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  • Senior Analyst - Client Audit

    CVS Health (Jefferson City, MO)
    …team in an Sr. Analyst role. This is a client facing project management / auditor position that is responsible for coordinating, managing, tracking, reviewing, ... of exceptions identified during the audit process, specifically related to pharmacy claims and manufacturer rebates. This includes having a working knowledge base… more
    CVS Health (03/14/25)
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  • Manager Tax Mergers and Acquisitions

    Emerson (St. Louis, MO)
    …responsible for tax aspects of acquisitions, divestitures and internal restructurings, the management of the Company's tax examinations, research and planning for US ... effective tax rate and/or increase cash flow, and project management . As a Manager, you are encouraged to carry...the function with moderate supervision and mentorship from the Director or other senior personnel. You must be able… more
    Emerson (01/17/25)
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  • Clinical Letter Writer (Part-time) - RN, LVN/LPN…

    Evolent (Jefferson City, MO)
    …to both members and providers + Appropriately identifies and refers quality issues to the Senior Director of Medical Management or Medical Director . ... necessary/required. + Participates in continuing education initiatives. + Collaborates with Claims , Quality Management and Provider Relations Departments as… more
    Evolent (03/11/25)
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  • Zurich Direct Markets F&I Executive - St. Louis

    Zurich NA (Jefferson City, MO)
    …and competitors. * Extensive experience in retail automotive finance or senior sales management (eg GM, GSM, Finance Director , Finance Manager). * Experience in ... flexibility, travel, a competitive base salary with uncapped incentives, excellent benefits ( Medical , Dental, 401k, PTO), and a company car (subject to a driving… more
    Zurich NA (03/13/25)
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