- Trustmark (Nashville, TN)
- …the best to our colleagues, clients and communities. Responsible for overseeing a claims processing organization. Ensures claims are processed in a timely manner ... in accordance and compliant with government regulations. Develops claims adjudication policies and procedures that maximize the accuracy of claims payments.… more
- Humana (Nashville, TN)
- …of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations ... operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to...member PHI / HIPAA information + This is a remote position\#LI- Remote **Scheduled Weekly Hours** 40 **Pay… more
- Zurich NA (Nashville, TN)
- …Office, AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-MD1 #LI- DIRECTOR ... Sr. Claims Specialist - Complex Construction Claims 117562 Zurich North America is seeking a skilled and experienced Senior Claims Specialist to join our… more
- Takeda Pharmaceuticals (Nashville, TN)
- …to bring life-changing therapies to patients worldwide. Join Takeda as Associate Director , Global Labeling Lead where you will be responsible for the development ... to ensure consistency with the overall product strategy, product claims and information in the CCDS and to ensure...around the world. This position is currently classified as " remote " in accordance with Takeda's Hybrid and Remote… more
- HealthEdge Software Inc (Nashville, TN)
- **Overview** ** Director , Product Management** **Position Overview:** We are seeking a highly skilled and experienced Director of Product Management to lead our ... and QE. We have divided our product teams into Value Streams (ie, Claims , Billing & Financials, Enrollment, BlueCard, Integration, and Platform). Each Value Stream… more
- Educational Testing Service (Nashville, TN)
- …education and ed tech space as it continues to grow and evolve. The Executive Director of Learning Design will lead the strategy for how ETS develops learning and ... assessment solutions in the K16 Business Unit. The Executive Director will lead a team of learning scientists, instructional designers, user experience research and… more
- Humana (Nashville, TN)
- …Corporate Medical Director relies on medical background and reviews health claims and preservice appeals. The Corporate Medical Director works on problems ... and complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of… more
- Elevance Health (Nashville, TN)
- **JR130960 Business Change Director (Quality Control Test Architect, PBM systems)** CarelonRx's Business Operations org is looking to hire a PBM Test Program Manager ... business system integrations. **Location:** This position will work in a hybrid model ( remote and office) with once a week from the nearest Elevance Health… more
- RELX INC (Brentwood, TN)
- Director of Data Content and Strategy About the business: LexisNexis Risk Solutions is the essential partner in the assessment of risk. Within our Healthcare ... and experienced professional to join our team as the Director of Data Content and Strategy. This critical role...Maintaining a deep understanding of relevant industry data, including claims , provider data, and patient insights. + Performing all… more
- Prime Therapeutics (Nashville, TN)
- …we make. **Job Posting Title** Clinical Research Analyst, Senior - Remote **Job Description** The Senior Clinical Research Analyst works collaboratively within ... data output using eligibility data, medical and pharmacy administrative claims . The individual will support pharmaceutical manufacturer value-based contract… more
- Prime Therapeutics (Nashville, TN)
- …and drives every decision we make. **Job Posting Title** Data Scientist- REMOTE **Job Description** The Principal Data Scientist is an independent statistical ... program impact measurement using eligibility, medical, and pharmacy administrative claims and external data, (eg, care management, disease management, laboratory,… more
- Prime Therapeutics (Nashville, TN)
- …every decision we make. **Job Posting Title** Regulatory Analyst Sr - Remote **Job Description** The Senior Regulatory Analyst is responsible for leading portions ... Programs, Compliance, Healthcare Reform, Legal, Networks, Clinical Operations, Paper Claims , Member Materials, IT, etc.) to ensure effective collaboration,… more
- LifePoint Health (Brentwood, TN)
- …with health plans to minimize the possibility of delay or non-payment of claims for services rendered by practitioners. * * *Responsibilities:* * Perform job ... Update and maintain CAQH database with provider information from Market Director . * Input and maintain provider data, including demographics, medical documentation,… more
- HUB International (Brentwood, TN)
- …digital capabilities and sophisticated data and analytics. **About Avant:** Avant Specialty Claims was founded in 1990 as Specialty Claims , Inc., and ... The ASC Team is made up of highly skilled claims professionals ready to offer person to person hands...lines of business under the technical direction of the Director of Subrogation. + Negotiate settlements within a predetermined… more
- Zurich NA (Nashville, TN)
- …AM - Remote Work (US) Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-BN1 #LI- DIRECTOR #LI-HYBRID ... Zurich's Philadelphia office. We are also open to hiring remote talent. This role will be filled at either...and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance… more
- Zurich NA (Nashville, TN)
- …Office, AM - Oregon Virtual Office Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LB1 #LI- DIRECTOR ... prospect/existing customer base. + Providing periodic support to the Claims Department with technical assessment of complex claims...for resume submission. Location(s): AM - Schaumburg, AM - Remote Work (US), AM - Dallas, AM - San… more
- Intermountain Health (Nashville, TN)
- …Compensation Analyst provides compensation support and analysis for the Director of Physician Compensation, Manager of Physician Compensation, Medical Group, ... Recruiting, Professional Staff Services, and other leaders. **This is a 100% remote position** **however, currently we are unable to consider candidates for … more
- Zurich NA (Nashville, TN)
- …Park, AM - Tennessee Virtual Office Remote Working: Hybrid Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-JJ1 #LI- DIRECTOR ... and 14 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance...and 12 or more years of experience in the Claims or Underwriting Support area + Experience with Microsoft… more
- HomeSafe Alliance (Nashville, TN)
- …with GHC pricing requirements and report actual performance monthly to the Director of International Operations (DIOps) + Verify and assess accuracy of transit ... risks of not meeting RDDs as directed by the Director of International Operations, for all shipments that may...International Operations, for all shipments that may create inconvenience claims for HomeSafe. Formats and data requirements to be… more