- Banner Health (Phoenix, AZ)
- …effectiveness of risk mitigation strategies. 9. Oversight for investigation and evaluation of complex claims and manages such claims through mediation and/or ... Claims Mgmt **Work Shift:** Day **Job Category:** Legal The **Executive Director , Claims & Litigation Counsel** will provide strategic and operational… more
- Humana (Phoenix, AZ)
- …understand how to operationalize this knowledge in their daily work. The Medical Director 's work includes computer-based review of moderately complex to ... of our caring community and help us put health first** The Medical Director actively uses their medical background, experience, and judgement to make determinations… more
- Microsoft Corporation (Phoenix, AZ)
- …claims management processes. This role reports to the Microsoft CO+I EPC GSC Senior Director of Global Claims and works seamlessly with the Regional Claims ... The **Senior Construction Claims Analyst** shall work seamlessly with the Global...Claims . This team supports a global portfolio of complex , multi-disciplinary, multi-billion-dollar, multi-year datacenter construction projects across all… more
- Humana (Phoenix, AZ)
- … relies on medical background and reviews health claims . The Medical Director work assignments involve moderately complex to complex issues where ... The Medical Director 's work includes computer based review of moderately complex to complex clinical scenarios, review of all submitted clinical records,… more
- Celestica (Phoenix, AZ)
- …Supply Chain Management (SCM) **Career Stream:** Supply Chain Management (SCM) **Role:** Director 1 (DR1) **Job Title:** Director , Strategic Supply Chain ... dynamic market environment. **Detailed Description** We are currently seeking a ** Director , Strategic Supply Chain Management (Capital Equipment)** to join our team… more
- Humana (Phoenix, AZ)
- …The Corporate Medical Director relies on medical background and reviews health claims . The Corporate Medical Director works on problems of diverse scope and ... complexity ranging from moderate to substantial. The Corporate Medical Director provides medical interpretation and decisions about the appropriateness of services… more
- Merck (Phoenix, AZ)
- **Job Description** The Associate Director Data Science will be responsible for developing and communicating data-driven and actionable insights that drive greater ... analyze data leveraging advanced analytical/statistical techniques from disparate databases/sources ( claims data/EMR Data and other sources) to drive optimization… more
- Microsoft Corporation (Phoenix, AZ)
- …for Microsoft's cloud business. The MS portfolio consists of complex , multi-disciplinary, large scale, multi-year datacenter construction and lease projects. ... The CO+I, Datacenter business is looking to fill the role of Global **Contracts Quality Director ** . The Contracts Quality director has a role in overseeing and… more
- Evolent (Phoenix, AZ)
- …health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek ... health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek… more
- Molina Healthcare (Phoenix, AZ)
- …years leadership/supervisory experience required * Progressive management experience to manage complex work systems and workflows required * Knowledge of pre-edit ... Access, Word and Excel * Knowledge and understanding of claims processing systems and medical claims * Knowledge of HMO, PPO, POS, MCO, Medicare, Medicaid,… more
- Zurich NA (Phoenix, AZ)
- …+ Understands, analyzes, and applies the component parts of an insurance policy for complex claims . + Ability to follow reserving process for indemnity and ... expense in analyzing the potential exposure of complex claims . + Ability to determine the...Office, US_55 (US_55) Remote Working: Yes Schedule: Full Time Employment Sponsorship Offered: No Linkedin Recruiter Tag: #LI-LC1 #LI- DIRECTOR … more
- Prime Therapeutics (Phoenix, AZ)
- …or enhanced financial pricing strategies. This position will also lead highly complex financial pricing analyses, and provide consultation and analytic insight to ... Recommend new and revised financial pricing programs based on analysis of pharmacy claims data, average wholesale drug prices (AWP), and other relevant data of… more
- Prime Therapeutics (Phoenix, AZ)
- …new product development. **Responsibilities** + Analyze or produce reports of varied claims data to assess Prime's products and/or programs; utilize analytics to ... based upon large data sets and/or experience working with complex queries + 3 years of experience with dashboard...+ Prior PBM experience or experience working with medical claims , pharmacy claims , healthcare and/or benefits data… more
- Zurich NA (Phoenix, AZ)
- …Liability Underwriter, (Sr. Level III or AVP Level IV) you will handle complex new and renewal domestic Construction Professional Liability accounts and serve as a ... Diploma or Equivalent and 10 or more years of experience in the Claims or Underwriting Support areaOR + Zurich Certified Insurance Apprentice including an Associate… more
- Prime Therapeutics (Phoenix, AZ)
- …with high-complexity pricing analyses. **Responsibilities** + Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness & ... accuracy of Prime's financial pricing programs against adjudicated claims to identify trends and draw insights to provide...accuracy + Demonstrated ability to problem solve and interpret complex data + Ability to work independently and meet… more
- Stantec (Chandler, AZ)
- …with Earned Value management and forecasting. + Experience with scheduling large, complex projects. + Experience with claims management for design projects. ... be based on Project/Client needs as well as proactive Claims /Risk mitigation. + Oversee and approve the development and...(PGC) Monthly Reports; issue following review with the Design Director . + Responsible for the formulation of the Project… more
- Mathematica (Phoenix, AZ)
- …data pipelines and analyses involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources such as EHRs and ... and Mathematica's contractual and regulatory requirements. * Act as Project Director on select awarded projects, ensuring successful execution from kickoff through… more
- Prime Therapeutics (Phoenix, AZ)
- …Evaluates the utilization and financial experience of customers and prospects + Performs claims re-pricing analyses of moderately complex external claims ... and ability to adjust focus **Reporting Structure** + Reports to Manager or Director in the Finance Department Potential pay for this position ranges from $59,000.00… more
- Prime Therapeutics (Phoenix, AZ)
- …is responsible for managing, analyzing, and delivering Treasury reporting, including complex liquidity reporting and claim payment process reporting for a variety ... Team and guidance to the Accounting, Finance, Information Technology and Claims operation functions. **Responsibilities** : + Develop, manage, and advance monthly… more