- Ryder System (Harrisburg, PA)
- …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
- CVS Health (Harrisburg, PA)
- …during the plan year. The **Medicare** **Benefits Standards & Guidance Lead Director ** ensures accountability for the implementation, management , and maintenance ... Employer Groups. The **Medicare** **Benefits Standards & Guidance Lead Director ** acts as the point of contact to our...such as Benefit & Product Strategy, Benefits & Product claims configuration, Medicare Service Operations (MSO), Medical … more
- Humana (Harrisburg, PA)
- …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 (Harrisburg, PA)
- …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 (Harrisburg, PA)
- … 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
- Genesis Healthcare (Pennsburg, PA)
- …or In-Training (IT) Director of Rehab is responsible for assisting the Director of Rehab in the efficient management of rehabilitation services in his/her ... place for you. **Why Powerback?** + **Benefits:** We offer Medical , Dental, and Vision plans to Full-Time and Part-Time...rehabilitation services in all settings. The Assistant or IT Director of Rehab supports the delivery of the highest… more
- Commonwealth of Pennsylvania (PA)
- Director , Health Insurance Office, PSERS Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4863799) Apply Director , Health Insurance Office, ... care? The Public School Employees' Retirement System (PSERS) is looking for a Director of the Health Insurance Office to oversee our unique post-employment Health… more
- Aveanna Healthcare (Exton, PA)
- …to the Governing Body, also reporting to Area Vice President, AVP, and/or Area Director , AD. Essential Job Functions Team Management : * Assure evaluation of each ... Executive Director - Home Care ApplyRefer a FriendBack Job...Details Requisition #: 203568 Location: Exton, PA 19341 Category: Management Salary: $70,000.00 - $75,000.00 per year Position Details… more
- Takeda Pharmaceuticals (Exton, PA)
- …strategies. + Provide product development and label development strategies to ensure promotional claims can be supported. + May provide management of individuals ... to the best of my knowledge. **Job Description** **Associate Director , US Advertising & Promotion Regulatory Review** **Takeda Pharmaceutical**...office. Where you will be working on the US Medical team, you will be empowered to serve as… more
- EPAM Systems (Philadelphia, PA)
- …driving strategic and operational excellence across client functions such as underwriting, claims and distribution management . You will contribute to the ... - go-to-market, sales, engagement delivery and practice development. As a **Managing Director - Insurance Advisory** , you will lead the demand generation, pursuit,… more
- CVS Health (Blue Bell, PA)
- …driving the organization's modernization efforts and enhancing our critical assets, including Claims , Eligibility, and Plans. The Executive Director will develop ... more personal, convenient and affordable. **Position Summary** The Executive Director , Application Development- Commercial claim and reimbursement will define and… more
- J&J Family of Companies (Horsham, PA)
- …& Johnson is seeking an accomplished and strategic leader to assume the role of Director , Data Strategy and Innovation - Oncology to be located in Horsham, PA and/or ... can reach their potential. At Johnson & Johnson, we all belong. This Director , Data Strategy and Innovations - Oncology will lead and coordinate activities related… more
- Prime Therapeutics (Harrisburg, PA)
- …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
- IQVIA (Wayne, PA)
- …(CDO, CAO, VP), Technology (CIO) and Business Areas (Pharmacy, Care Management , Care Coordination, other), with demonstrated success selling technology based ... success selling the following types of technology based professional services: Data Management (master data management , data governance, data quality, data… more
- Trustmark (Harrisburg, PA)
- …+ 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
- UPMC (Pittsburgh, PA)
- …clinical coding edits. Additionally, participates in cross-functional efforts including the Claims Operations, Systems Configuration, Medical Policy, & IT ... and internal stakeholders in the development and maintenance of claims payment and medical policy edits based...in departmental functions and special projects. + Document daily claims performance for claim edits and advise management… more
- UPMC (Pittsburgh, PA)
- …clinical coding edits. Additionally, participates in cross-functional efforts including the Claims Operations, Systems Configuration, Medical Policy, & IT ... and internal stakeholders in the development and maintenance of claims payment and medical policy edits based...Health Plan specific clinical and payment policy. + Advises management if edits are working as intended and supports… more
- Stantec (Philadelphia, PA)
- …and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. + Sound knowledge and experience ... context of the communities we serve, we provide planning, engineering, and infrastructure management services that fit the needs of our clients and improve the… more
- AmeriHealth Caritas (Philadelphia, PA)
- …appeals, the analysis of claims and appeals, and the review of medical management authorizations.; + Research and Investigate member and/or provider appeals ... making or example, internal committee/panel, independent review organization, internal medical director - as process dictates +...ensure proper handling of the appeal eg UM team, medical directors, claims , contact center, vendors as… more
- Walmart (Woodland, PA)
- …Hygiene and Safety Technician; Safety Trained Supervisor; North American Transportation Management Institute Certified Director of Safety; North American ... Transportation Management Institute Certified safety Supervisor; Safety Management Specialist; Certified Safety Manager; Safety Director ; Licensed Safety… more