- Humana (Providence, RI)
- …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
- Humana (Providence, RI)
- …career to the next level by driving real impact and shaping the future of claims management? As a Senior Pharmacy Claims Professional, you will play a pivotal ... in resolving outstanding balances related to claim reversals, all while leading process improvements and influencing departmental strategies. This is your chance to… more
- American Heart Association (Providence, RI)
- …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 (Providence, RI)
- **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 (Providence, RI)
- …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 (Providence, RI)
- …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
- Prime Therapeutics (Providence, RI)
- …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
- Bank of America (Lincoln, RI)
- …use a multi-faceted approach for flexibility, depending on the various roles in our organization . Working at Bank of America will give you a great career with ... client attrition, client profitability, etc. and manages business development process . Executes business/strategic planning process across sub-lines of… more
- Sunrun (Providence, RI)
- …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 (Providence, RI)
- 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 (Providence, RI)
- …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 (Providence, RI)
- … 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
- Wolters Kluwer (Providence, RI)
- …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
- Elevance Health (Smithfield, RI)
- …+ Executes client-specific operational deliverables including benefit set up, reporting, and project support as needed. + Leverages data to track account performance ... Management is highly preferred. + Exceptional strategic thinking, analytical, organization , decision-making, problem-solving skills, and adaptability highly preferred. +… more
- Humana (Providence, RI)
- …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 (Providence, RI)
- …**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
- Sumitomo Pharma (Providence, RI)
- …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
- Elevance Health (Smithfield, RI)
- …Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider ... to provider premises during contract negotiations. + Participates on project team involved with enterprise-wide initiatives. **Minimum Qualifications:** + Requires… more
- Ducommun (Warren, RI)
- …(Operations, SC, Finance, Quality and Engineering). 2. Policy, Procedure and Process Administration: * Interfaces and communicates with employees regarding basic HR ... including assisting with general benefit inquiries and online enrollment, claims resolution, collection of required documents, invoicing and payroll adjustments,… more
- Grundfos (Providence, RI)
- …time (warranty claims , working hours FAS etc); + Assists in project execution - installation support, commissioning etc; + Executes agreed maintenance services ... Type: Regular **_Would you like to work in an international, innovative organization , where we produce high-quality solutions and are constantly looking to enhance… more