- Humana (Trenton, NJ)
- … 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
- 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
- Humana (Trenton, NJ)
- … 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
- J&J Family of Companies (Horsham, PA)
- Associate Director , AI for Medical Data and Advanced Analytics + Job titleAssociate Director , AI for Medical Data and Advanced Analytics + FunctionData ... & Johnson Innovative Medicine is searching for an Associate Director , AI for Medical Data and Advanced...priorities. Competencies: + Hands - on experience using healthcare claims datasets, electronic health records, and specialty pharmacy data… more
- Humana (Trenton, NJ)
- …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
- Rowan University (Glassboro, NJ)
- …and EHS claims investigation and mitigation; coordinates response with Risk Management and Public Safety on all asset related matters. + Coordinates and oversees ... Director of Environmental Health and Safety & Fire...Operations and campus community, this Department leads the overall management of facilities operations including Trades, Central Plant Operations,… more
- The Cigna Group (Philadelphia, PA)
- …and support delivery of plan KPIs. + Oversee end-to-end operations, including claims management , contract administration, account management , and producer ... revenue annually with earnings of approximately $1B. The senior director of Stop Loss will be responsible for protecting...risk, and presenting innovative solutions to the market. The management process will pull in dedicated leaders who drive… more
- J&J Family of Companies (Horsham, PA)
- …Sciences - Data Science + Titusville, United States; Horsham, United States **Associate Director , AI for Medical Data and Advanced Analytics** + Data Analytics ... Associate Director , AI & Advanced Analytics for Patient Support...on (coding knowledge preferred) experience integrating and analyzing healthcare claims , electronic health records, lab results, specialty pharmacy, SDOH/consumer,… more
- Takeda Pharmaceuticals (Exton, PA)
- …strategies. + Provide product development and label development strategies to ensure promotional claims can be supported. + May provide management of individuals ... my knowledge. **Job Description** Join Takeda as an Associate Director , US Advertising & Promotion Regulatory Review out of...office. Where you will be working on the US Medical team, you will be empowered to serve as… more
- Sedgwick (Trenton, NJ)
- …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
- Takeda Pharmaceuticals (Trenton, NJ)
- …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
- Olympus Corporation of the Americas (Center Valley, PA)
- …**__** Every day, we live by our philosophy, True to Life, by advancing medical technologies and elevating the standard of patient care so people everywhere can ... other than @Olympus.com, it is likely not legitimate._ **Job Description** The Director Scientific Communications, Global Operations plays a central role in the… more
- Wells Fargo (Wilmington, DE)
- …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 (Wilmington, DE)
- …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 (Wilmington, DE)
- …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
- HomeSafe Alliance (King Of Prussia, PA)
- **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
- WTW (Philadelphia, PA)
- …Risk and Broking** Segment. The business supports an integrated approach to risk management by advancing "the analytical broker". Simply put, our purpose is to ... reduce the likelihood of claims and reduce the cost of incidents when they...Role** We have an exciting opportunity as an Associate Director within our **North America Enterprise Risk Consulting** practice,… more
- Evolent Health (Trenton, NJ)
- …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
- J&J Family of Companies (Horsham, PA)
- …Sciences - Data Science + Horsham, United States; Titusville, United States **Associate Director , AI for Medical Data and Advanced Analytics** + Data Analytics ... Manager, AI for Medical Engagement + Job titleManager, AI for ...years of relevant business experience in marketing, finance, analytics, management consulting or related field is required + A… more
- Stantec (Philadelphia, PA)
- …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... Claims /Risk mitigation. + Oversee and approve development and management of the Project Scope WBS. + Oversee and...Internal (PGC) Monthly Reports; issue following review with Design Director . + Responsible for the formulation of the Project… more