- Humana (St. Paul, MN)
- … 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 (St. Paul, MN)
- …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 (St. Paul, MN)
- …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
- Evolent Health (St. Paul, MN)
- …including the CEO, CFO, CMO, pharmacy leadership, clinical operations/UM, medical economics/actuarial services/analytics, and vendor management . **Performance ... Management ** - maintain overall accountability for medical expense and P&L performance of designated client partners, including the facilitation of… more
- AON (Bloomington, MN)
- Client Service Reinsurance Associate Director Client Advocate Opportunity at Aon! This role is either Virtual, or Hybrid in our Bloomington, MN office! Are you on ... accounting + Lead or assist in project planning, strategic management and development of staff in core areas of...of insurance or reinsurance experience in an accounting, premium, claims , or broker client servicing role. + Successful completion… more
- Elevance Health (Mendota Heights, MN)
- …responsibility for Program Management and/or Medicare Integrity Operations. + Program Management includes but is not limited to: Claims , Grievance & Appeals, ... ** Director I Medicare Operations** **Location:** This position will...years professional/leadership experience with CMS, including strategic planning, project management , Medicare or related healthcare insurance or medical… more
- J&J Family of Companies (St. Paul, MN)
- …safety data, international regulatory safety databases, and other data sources, eg, claims and electronic medical records. This position develops and implements ... Associate Director , Signal Detection Scientist - 2406212640W **Description** Johnson...position is to lead the implementation of the Signal Management Group's aggregate surveillance strategies for proactive and systematic… more
- Cardinal Health (St. Paul, MN)
- …future. The Director , Managed Care is responsible for strategy and management of managed care contracts and relationships with payers. They are responsible to ... implement strategic initiatives related to payer contracts. The Director , Managed Care contributes to practice growth and profitability by providing contracting… more
- Sumitomo Pharma (St. Paul, MN)
- …a dynamic, highly motivated, and experienced individual for the position of ** Director , Market Access Insights** to support US Market Access strategic and tactical ... navigating complex organizational structures / experience in highly matrixed environments. The Director will be a member of the Commercial Insights team. This… more
- Takeda Pharmaceuticals (St. Paul, MN)
- …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
- Evolent Health (St. Paul, MN)
- …core Payer Data Warehouse datasets and Evolent Data Warehouse tables, including medical , pharmacy and ancillary claims data, membership data, clinical ... a growth mindset as we solve complex business problems. **Collaboration Opportunities** The Director , Client Analyst role will be serving as a strategic advisor to… more
- Sedgwick (Minneapolis, MN)
- …Great Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Director SAP Program **PRIMARY PURPOSE** **:** Directs the strategic planning, ... of SAP FICO and BRIM Solution Components, including Subscription Order Management (SOM), Convergent Charging (CC), Convergent Invoicing (CI), Contract Accounting… more
- Compass Group, North America (Minneapolis, MN)
- …and NHL, MLB, NBA, NFL, and MLS All-Star Games. Job Summary As a Director of Human Resources, you will be responsible for overseeing the recruitment, training and ... manager relationships, delivering on our service level agreement, requisition management , posting advertisements, sourcing, screening, and interviewing, candidate correspondence,… more
- Evolent Health (St. Paul, MN)
- …models using healthcare data (ie, both structured and unstructured data from operations, claims , and medical charts) to solve complex problems, drive innovation, ... in everything from scrubs to jeans. **Position summary** As an Associate Director , Data Scientist (Machine Learning Engineer), you will be responsible for… more
- HomeSafe Alliance (St. Paul, MN)
- **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
- Prime Therapeutics (Eagan, MN)
- …thorough understanding of pharmaceutical claims data and general understanding of medical claims data; highly analytical + Self learns new processes / ... requirements, system specifications, process flows, process change and/or project management + Participates in adopting operational best practices and standard… more
- Robert Half Office Team (Minneapolis, MN)
- …market * Conduct provider outreach to verify and confirm provider demographics and medical record requests * Perform medical record reviews for risk adjustment, ... EMR access or onsite * Schedule on-site reviews with provider offices, medical groups and other clinical facilities depending on geographical location * Maintain… more
- Prime Therapeutics (St. Paul, MN)
- …+ Experience writing SQL queries + Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data + ... as assigned **Minimum Qualifications** + Bachelor's Degree in Business Administration, Management , Economics or related area of study, or equivalent combination of… more
- Evolent Health (St. Paul, MN)
- …leaders across the organization, training and development, provider relations, member services, claims management and our implementation team will also be ... plans and serves in a supporting role to the Director , Intake and Utilization Management Operations. +...population management or managed care/insurance or hospital medical management department setting may be substituted… more
- The Cigna Group (Eden Prairie, MN)
- …client account. You will collaborate with other data and analytics teams and medical management business leads to assess existing analytic tools and refine ... and outcomes. You will be responsible for the day-to-day management of an analytical staff as well as the...and CHAM clinical functions + Closely collaborate with client-dedicated Medical Director and Clinical Program Manager to… more