- Humana (Salem, OR)
- …independent determination of the appropriate courses of action. **Where you Come In** As a Claims Process Organization Project Manager II you will manage ... caring community and help us put health first** The Project Manager II manages all aspects of a ... + Communicate with other operational areas in the organization to secure specialized resources and contributions for the… more
- CareOregon (Portland, OR)
- … processing, prior authorizations, formulary exceptions, appeals, grievances, and project participation. Essential Responsibilities Customer Service and Claims ... benefit policies. + Document all customer service activities according to organization requirements. + Follow policies and procedures to answer questions from… more
- American Heart Association (Portland, OR)
- …such as code book, Case Report Forms, Surveys, EHR queries and other data project documentation process . + Develop and implement guidelines to manage data ... for you to be able to integrate data from different sources (clinical, claims , patient-reported survey data, food vendors). The Database Designer is responsible for… more
- Guardian Life (Salem, OR)
- **Job Posting Title** **Team Leader, Absence Claims Management** **Job Description** The **Team Leader, Absence Claims Management** is responsible for leading a ... Managers to get results within their team and the organization . The Team Leader will serve as a primary...action plans for improvement. + Review processes/reports regularly for process improvement opportunities. + Own relationship with client and… more
- Norstella (Salem, OR)
- …Now, Citeline is proud to be a part of Norstella, an organization that consists of market-leading pharmaceutical solutions providers united under one goal: ... to improve patient access to life-saving therapies. Within this organization , Citeline plays a key role in helping clients connect the dots from pipeline to patient.… more
- Emerson (Salem, OR)
- …Engineer to oversee and manage projects related to feeding systems in our organization . The successful candidate will coordinate and lead projects from conception to ... proposal with the sales team, making adjustments as necessary. Overall Project Responsibility: + Assume end-to-end project responsibility, ensuring consistency… more
- EM Key Solutions, Inc. (Remote, OR)
- …Pension Claims Automation by bringing their expertise in Business Process Modeling, systems engineering concepts, and software design concepts. Duties: + Support ... Effort's structure, policies, and operations and recommend solutions that enable the organization to achieve its automation goals. + Support the contract team in… more
- Prime Therapeutics (Salem, OR)
- …Description** + Performs exploratory data analysis and data mining of healthcare claims and authorizations data. + Designs, documents, develops and rolls out ... reports that give a detailed description of the current project 's progress and indicates time devoted to each task...in easily understandable format for varying levels of the organization . **Responsibilities** + 3+ years of transact-SQL (MS SQL… more
- Stantec (Portland, OR)
- …corrective actions, and develop and share lessons learned. + Identify and lead process improvements in alignment with business or HSSE strategic goals. + Provide ... work practices, as well as local legislation. + Provide technical assistance to project teams with pre-job planning and hazard assessments for field activities and… more
- Sunrun (Salem, OR)
- …branch relationships including weekly/monthly reviews, utilization and workload management, process updates and identification and resolution of specific market and ... process issues + Work to pursue and achieve tactical...that require cross-functional engagement with key staff across the organization and external stakeholders + Launch initiatives that increase… more
- Takeda Pharmaceuticals (Salem, OR)
- By clicking the "Apply" button, I understand that my employment application process with Takeda will commence and that the information I provide in my application ... **About the role:** At Takeda, we are a forward-looking, world-class R&D organization that unlocks innovation and delivers transformative therapies to patients. By… more
- Prime Therapeutics (Salem, OR)
- …processes and plans to mitigate future risk. + Lead coordinated efforts across the organization to implement new program or process changes for the client. ... minimization of expense and reporting of performance measures including drug claims processing + Create and maintain strategic partnerships with customers through… more
- Wolters Kluwer (Salem, OR)
- … project life cycle; contributing to and executing department process improvement initiatives; managing time and resources effectively; maintaining performance ... increase operational efficiency and reduce costs. Corporate legal and insurance claims departments trust our innovative technology and end-to-end customer experience… more
- Timber Products Company (White City, OR)
- …program for Table Rock Composite Specialties. Ensures standardization of process /quality control platforms and quality performance metrics. Responsible for the ... of safe behaviors on a consistent basis. + Determines departmental quality project plans and structured implementation schedules. Manages the progress of quality… more
- Wolters Kluwer (Salem, OR)
- …and not afraid of the hunt. Someone that prefers to navigate the entire sales process , from start to finish, run their own demos, build a strong and lasting ... entity or claim management - Legisway covers end-to-end legal department needs (corporate, claims , IP, Data Privacy, and so much more!). Legisway is used by legal… more
- Providence (OR)
- …that enables collaboration with external teams in the audit and recovery process + Coordinate with parties with compliance accountabilities to facilitate corrective ... processing of risk report intake triage, timely processing of prepay audit claims , and other compliance requirements **_Please note the following important detail… more
- Humana (Salem, OR)
- …projects and initiatives, partnering and collaborating with multiple areas across the organization . + Develops or has a deep understanding of physician networks, ... physician performance and rating metrics ( claims , measures, conditions, specialties, etc.), product offerings, and analytics-based approaches which produce… more
- Sunrun (Salem, OR)
- …**ESSENTIAL DUTIES AND RESPONSIBILITIES** + **Represent the customer within the organization , collaborating with the technology team to align product developments ... + **Facilitate research and investigation into Sales ROE (Rules of Engagement) claims , working with customer care and compliance teams to ensure fair outcomes.**… more
- Providence (OR)
- …analyzing data, and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare ... on bid pricing outcomes + Analyzing and interpreting healthcare claims data, enrollment data, and other relevant information to...accuracy and completeness of data used in the pricing process + Staying informed of changes in risk adjustment… more
- Sumitomo Pharma (Salem, OR)
- …the Medicaid rebate team in receiving, processing, validating, trouble-shooting Medicaid claims and dispute resolution with state agencies. This position requires a ... as it relates to Model N implementation and payment process . + Lead subject matter expert (SME) for shared...Proficient in MS Office (Word, Excel, Access, PowerPoint, MS Project , Visio, SharePoint). + Customer-focused ability to communicate across… more