- Humana (Providence, RI)
- … 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 (Providence, RI)
- … 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 (Providence, RI)
- …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
- Sedgwick (Providence, RI)
- …+ Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service ... work. Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director , Network Operations **PRIMARY PURPOSE** : To be responsible for the… more
- Cardinal Health (Providence, RI)
- …are used. **What this position contributes to Cardinal Health:** The Associate Director , Access and Patient Support (APS) is responsible for the tactical execution ... collaboration and integration with cross functional teams. The Associate Director oversees revenue and budget accountability, organizational development, and… more
- Sedgwick (Providence, RI)
- …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 (Providence, RI)
- …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
- HomeSafe Alliance (Providence, RI)
- **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
- Evolent Health (Providence, RI)
- …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
- Fujifilm (Providence, RI)
- …limited management oversight. The position will report to the Director of Corporate Compliance. **Duties and responsibilities** + Develop and implement elements ... needs of healthcare across prevention, diagnosis, and treatment. Fujifilm's medical imaging portfolio includes solutions for digital radiography, mammography,… more
- University Medicine (East Providence, RI)
- …staff meetings. + Maintain office in regulatory compliance (OSHA). + Participate in medical claims processing; assist with charge entry and eligibility checks. + ... Medicine Customer Service Standards. + Actively participates with Practice manager in management of site. + Implement and upholds Brown Medicine policies and… more
- CVS Health (Providence, RI)
- …Summary** As a Payer Relations Account Executive, you support a Payer Relations Director (PRD) in managing one of the largest and most complex PBM relationships ... retention, clinical program partnerships, specialty network contracting, and other claims -processing operational efficiencies. This individual may also have responsibility… more