- Ryder System (Lincoln, NE)
- …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
- Humana (Lincoln, NE)
- …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 (Lincoln, NE)
- …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 (Lincoln, NE)
- … 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
- Molina Healthcare (Omaha, NE)
- …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
- Merck (Lincoln, NE)
- **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
- Pfizer (Lincoln, NE)
- …opportunities for improving patient care, closing quality gaps, and addressing population health management . + Serve as the Field Medical Outcomes lead for ... in field-based medical /outcomes role. + Experience analyzing health care data ( claims , electronic health records, other health care data) + Expertise in Clinical… more
- Mass Markets (NE)
- …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
- Prime Therapeutics (Lincoln, NE)
- …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
- Molina Healthcare (Omaha, NE)
- …* Proficiency in Microsoft Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, ... from root cause analysis through implementation * Oversees vendor FWA case management including tracking on schemes, coordinating internal efforts with vendor to… more
- Mass Markets (NE)
- …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
- Trustmark (Lincoln, NE)
- …+ 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
- Molina Healthcare (Omaha, NE)
- …for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims ... system requirements of customers as it pertains to contracting, network management and credentialing. **Knowledge/Skills/Abilities** * In conjunction with the … more
- UMB Bank (Lincoln, NE)
- …across all payment channels. Will work with the Enterprise Fraud Prevention and Claims teams to provide data to help identify emerging fraud trends and UMB's ... concert with the Enterprise Fraud Prevention and Enterprise Fraud Claims teams to identify fraud exposure and make necessary...to fulfill overall business needs and expectations of the Director of Enterprise Fraud Operations and the bank's senior… more
- Intra-Cellular Therapies, Inc (Omaha, NE)
- Benefits Offered 401K, Dental, Life, Medical , Vision Employment Type Full-Time "We deliver innovative treatments to improve the lives of individuals suffering from ... by high impact resource allocation decisions. DMs will assume ownership and the management of a wide range of customer interactions as well as accountability for… more
- Cardinal Health (Lincoln, NE)
- …on policies. **_Manager, Ethics and Compliance_** Reporting to the Compliance Director , this position is responsible for supporting the programmatic requirements for ... focus include: compliance training, policy development, exclusion screening tracking, management of investigations and development of programmatic presentation materials.… more
- Healthfirst (NE)
- …productivity and quality for each Specialist against expectations + Prepare cases for Medical Director Review ensuring that all pertinent information (ie case ... + Experience in clinical practice with experience in appeals & grievances, claims processing, utilization review or utilization management /case management .… more
- Zurich NA (Omaha, NE)
- …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